For patients who are truly disabled by tennis elbow (many experience difficulty with such simple daily functions as lifting a cup of coffee, writing, or shaking hands) and have not benefited from conservative treatments, surgery may be advised.
Two surgical techniques are available – open surgery and elbow arthroscopy.
Requires a larger incision. A little chip of bone is removed that increases blood flow and promotes healing and reduces pain. Alternatively, a small portion of the tendon can be released by severing its connection to the bone. This reduces pain. Debridement of the unhealthy portion of the muscle.
In this two small cuts are made: one on the medial (inner) side and one on the lateral (outer) side of the elbow. The surgeon uses an arthroscope to clean out all of the torn-off tissue.
Recovery and Rehabilitation
Following surgery, patients who have arthroscopic treatment are not splinted, but simply have the elbow covered and wear a sling. They may begin gentle stretching exercises of the wrist and elbow in the immediate postoperative period as tolerated. Supervised physical therapy is initiated if the patient is failing to regain adequate motion or strength in the month following treatment.
For patients who have open debridement, the wrist is usually splinted in extension for three to six weeks to allow healing of the repaired and reattached tendon. The patient then begins gentle stretching and strengthening with supervision of a physical therapist or hand therapist.