Lateral Epicondylitis Surgical Treatment

Lateral epicondylitis, also known as tennis elbow, is a condition characterized by pain and inflammation on the outside of the elbow, where the muscles and tendons of the forearm attach to the lateral epicondyle. Surgical treatment is usually considered when conservative treatments have failed to provide relief.

Indications for Surgery

Surgery is typically recommended for patients with lateral epicondylitis who have:

• Persistent pain and limited function despite 6-12 months of conservative treatment
• Severe pain that interferes with daily activities or sleep
• Significant loss of grip strength or elbow function

Surgical Procedures

There are several surgical procedures used to treat lateral epicondylitis, including:

• Open release surgery: This involves making an incision on the outside of the elbow to release the affected tendons and remove any damaged tissue.
• Arthroscopic surgery: This is a minimally invasive procedure that uses a small camera and instruments inserted through tiny incisions to visualize and treat the affected area.
• Percutaneous release surgery: This involves using a needle or other instrument to release the affected tendons through a small puncture in the skin.

Surgical Techniques

Some common surgical techniques used in lateral epicondylitis treatment include:

• Release of the extensor carpi radialis brevis (ECRB) tendon: This involves releasing the ECRB tendon, which is often implicated in lateral epicondylitis.
• Debridement of the lateral epicondyle: This involves removing any damaged or inflamed tissue from the lateral epicondyle.
• Decompression of the radial nerve: This involves relieving pressure on the radial nerve, which can contribute to pain and symptoms in lateral epicondylitis.

Postoperative Care and Rehabilitation

After surgery, patients typically require:

• Pain management: With medication and other interventions as needed.
• Immobilization: The elbow is often immobilized in a splint or cast for several weeks to allow the tendons to heal.
• Physical therapy: A rehabilitation program that includes exercises to improve range of motion, strength, and function.

Risks and Complications

As with any surgical procedure, there are risks and potential complications associated with lateral epicondylitis surgery, including:

• Infection
• Nerve damage
• Bleeding or hematoma
• Scarring or adhesions
• Persistent pain or stiffness

Outcomes and Prognosis

The outcome of lateral epicondylitis surgery can vary depending on the individual patient and the specific procedure used. Generally, patients can expect:

• Significant improvement in pain and function: In most cases, patients experience significant relief from symptoms and improved elbow function.
• Return to activities: Most patients are able to return to their normal activities, including sports and work, within several months after surgery.

Frequently Asked Questions (FAQs)

What is lateral epicondylitis?
Lateral epicondylitis, also known as tennis elbow, is a condition characterized by pain and inflammation on the outside of the elbow.

When is surgical treatment considered for lateral epicondylitis?
Surgical treatment is typically considered when conservative treatments have failed to relieve symptoms after 6-12 months.

What are the goals of surgical treatment for lateral epicondylitis?
The goals of surgery are to relieve pain, restore function, and improve quality of life by removing damaged tissue and promoting healing.

What are the common surgical procedures for lateral epicondylitis?
Common procedures include open or arthroscopic release of the extensor tendon, and removal of damaged tissue.

Is surgery always necessary for lateral epicondylitis?
No, most cases can be treated conservatively, and surgery is usually reserved for severe or persistent cases.

What are the potential risks and complications of surgical treatment for lateral epicondylitis?
Potential risks include infection, nerve damage, and recurrence of symptoms, among others.

How long does it usually take to recover from lateral epicondylitis surgery?
Recovery time varies, but typically ranges from several weeks to several months, with most patients regaining full strength and function within 6-12 months.

Can surgical treatment guarantee complete relief from symptoms?
While surgery can be effective in relieving symptoms, it may not guarantee complete relief, and some patients may experience residual pain or stiffness.

Are there any alternative treatments to surgery for lateral epicondylitis?
Yes, alternative treatments include physical therapy, bracing, and injections, among others, which may be tried before considering surgery.

Is surgical treatment for lateral epicondylitis usually covered by insurance?
Typically, yes, but coverage may vary depending on the specific insurance plan and individual circumstances.