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.