72017Feb

Surgery for Lateral Epicondylitis

More commonly known as tennis elbow, lateral epicondylitis is a painful disorder affecting tendons and muscles connected to the bump on the outside portion of an elbow.  Fortunately, symptoms eventually get better for most patients with conservative treatments.  However, a hand doctor might recommend surgery when pain incapacitates a patient after an extended period.

Overview of the Condition

According to the University of North Carolina, between 1 and 3 percent of individuals suffer from this disorder every year.  Age is the greatest risk factor.  Men and women develop the condition equally.  Three out of every four cases involve the arm of the individual’s dominant hand.

Around 90 percent of patients a hand specialist treats either conservatively or surgically report that their symptoms disappeared.  Fewer than 5 percent of sufferers require surgery.

While experts believe this disorder develops because of overuse, they have not pinpointed any exact causes, the American Academy of Orthopaedic Surgeons (AAOS) reports.  Most patients who suffer from it do not play tennis.

In most cases, symptoms emerge gradually.  Mild pain worsens over a period of as long as a few months.  Common indications include weak strength when gripping and the sensation of pain or burning in the affected area.  A hand surgeon uses X-rays, MRI scans, and electromyography (EMG) to aid in making a diagnosis.

When a Hand Specialist Recommends Surgery

Physicians who perform hand surgery treat most patients with conservative measures such as:

  • Resting the limb
  • NSAIDs
  • Physical therapy
  • Bracing
  • Injections of steroids
  • Shock wave therapy

According to the AAOS, when patients fail to respond to these treatments after six to 12 months, the hand doctor might suggest surgery.

The appropriate procedure is dependent upon a number of factors.  Among them are the scope of the patient’s injury, the individual’s overall health, and personal preferences and needs.  Doctors perform two basic types of tennis elbow surgery, both of which are same-day procedures:

  • Open surgery is the more common type of repair.  The physician makes a standard incision over the elbow.
  • Arthroscopic surgery utilizes tiny equipment through very small incisions.

The primary risks associated with surgery include infection, potentially long rehabilitation, damage to nerves and blood vessels, reduced strength, reduced flexibility, and possible additional surgery.

Approximately a week after surgery, the surgeon will take off a splint supporting the elbow and remove any sutures.  Rehabilitation starts roughly two months post-operatively.  Most patients are able to resume athletic activities within six months after a repair.  However, experiencing less strength in the affected arm is not uncommon.

The Mayo Clinic indicates that rehabilitation exercises are extremely important for patients who have undergone tennis elbow surgery.  Rehabilitation involves gradually boosting resistance to reduce the chance of another injury.  Resuming normal activity is possible when patients are able to accomplish motions that are both rapid and repetitive without pain.