When is tennis elbow surgery advised?

If the pain persists for several months, surgery may be advised. Fortunately there are several options for treatment:

• trim abnormal tendons 3-4 cm
• release tendon from bone
• ossatripsy

If tennis elbow surgery is to be considered, due to the inherent risks with any invasive surgery, most doctors will want to make sure that the patient has a pain level that prevents normal activity. Ideally, the patient has been given several cortisone shots with no improvement in the lateral epicondylitis pain.

What types of surgery are currently available? If the patient meets the criteria for tennis elbow surgery the current most common type of surgery is one of two types of invasive lateral epicondylitis surgery.

The first invasive tennis elbow surgery creates a 3 - 4 cm incision ( cut ) in the arm. The tendon sheaths are trimmed and the incision closed. The second type of invasive tennis elbow surgery also involves cutting open the arm and releasing the tendon from the bone with a scalpel.

Both of these invasive surgeries are performed on an outpatient basis with the patient going home the same day as the surgery. The treated arm is usually placed in a sling, although the arm may be place in a plaster cast based on how extensive the surgery was and based on the doctors assessment. The arm should be kept elevated to minimize swelling. It is also important to keep the arm dry to keep the arm healthy. Moisture may weaken the body's scar tissue in these initial stages. It is very important to follow your doctor's guidelines exactly to ensure you have the best surgical results.

As with any invasive surgery, both of the above tennis elbow surgery treatments have to follow risks:

• infection
• bleeding
• nerve damage
• slight loss of the ability to extend ( straighten ) the arm
• a scar on the skin surface that may be painful and/or unsightly
• persistant weakness in the arm and/or wrist

Recovery varies based on the doctor's assessment of the patients recovery from the surgery. Most patients are advised not to drive for a week. Stitches are usually removed 10 - 14 days after treatment. Rehabilitation of the arm begins after the doctor gives the go ahead.

I don't like the idea of being cut open, so fortunately there is a non-invasive option called OssaTripsy. A company called HealthTronics SSI was granted FDA approval in March 2003 for high energy orthopedic lithotripsy treatment of Lateral Epicondylitis.

This treatment has been found to be very effective method of treating chronic lateral epicondylitis.

How long does it take to recover? Recovery of lateral epicondylitis surgery varies patient to patient. Most patients are able to return to daily activity within 3 - 6 weeks. It is very important to realize that just because you arm do longer hurts it is not safe to engage in heavy activity or sports for 12 or more weeks. It takes a long time for the tendons to completely heal. Straining them by subjecting them to strong forces may cause delay healing if not cause permanent damage.