Table of ContentsView AllTable of ContentsWhat Is Tennis Elbow?IndicationsTypes of SurgeryWhat to ExpectRecoveryPossible Risks
Table of ContentsView All
View All
Table of Contents
What Is Tennis Elbow?
Indications
Types of Surgery
What to Expect
Recovery
Possible Risks
Tennis elbow surgery is a procedure that involves cutting the damaged elbow tendon at the point where it attaches to the bone. Surgery is only considered if all other conservative treatment options have been exhausted.
Also known as alateral humeral epicondylectomy(LHE), tennis elbow surgery is effective in around 85% to 90% of cases.Recovery can take several weeks or months to regain the full use of your elbow. Some people experience the loss of elbow and arm strength after the surgery, but postoperative rehabilitation can greatly reduce the risk.
This article explains what tennis elbow is, when surgery is needed, and what to expect before, during, and after surgery. It also describes how tennis elbow is commonly treated.
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Tennis elbow, also known aslateral epicondylitis, is due torepetitive stressthat causes pain and tenderness on the outer part of the elbow, called thelateral epicondyle.
The stress placed on the extensor tendon can causetendinosis(tendon degeneration) and the formation ofosteophytes(bone spurs) in the joint space. Pain can occur with certain movements of the elbow or when the wrist is bent back.
Who Needs Tennis Elbow Surgery?
Though tennis elbow often affects tennis players who use their elbows repetitively, people who engage in other repetitive elbow or wrist movements can also get it. These include occupations that require the repetitive, vigorous use of the forearm or the repetitive extension (lifting) of the wrist.
Examples include:
Non-Surgical Options
Once tennis elbow develops, it can take one to two years of conservative treatment to achieve sustained relief.
This includes conservative treatments like:
When Is Surgery Needed?According to the American Academy of Orthopedic Surgeons (AAOS), tennis elbow surgery is indicated when symptoms do not respond to conservative treatments for six months to a year. Between 3% and 11% of people with tennis elbow require surgical treatment.
When Is Surgery Needed?
According to the American Academy of Orthopedic Surgeons (AAOS), tennis elbow surgery is indicated when symptoms do not respond to conservative treatments for six months to a year. Between 3% and 11% of people with tennis elbow require surgical treatment.
Risks of Surgery Everyone Should Know
Types of Surgical Procedures for Tennis Elbow
There are different ways to perform an LHE:
None of the approaches are any more or less effective than the others.
Arthroscopic Elbow Surgery: What to Expect
What Happens During Tennis Elbow Surgery?
Types of AnesthesiaLocal anesthesiais commonly used, butregionalorgeneral anesthesiamay be recommended for certain open surgeries.
Types of Anesthesia
Local anesthesiais commonly used, butregionalorgeneral anesthesiamay be recommended for certain open surgeries.
Preparing for Surgery
Depending on the type of anesthesia used, fasting may or may not be required. If undergoing local anesthesia, there may be no food or drink restrictions.
If aregional blockorgeneral anesthesiais used, you will be asked to stop eating on the midnight before the operation. Up to four hours before surgery, you can take a few sips of water for any medications your surgeon has approved. Within four hours, no liquids or food should pass your lips.
Your surgeon will also advise you to stop taking NSAIDs like aspirin Advil (ibuprofen),Aleve (naproxen),Celebrex (celecoxib), and Voltaren (diclofenac) that promote bleeding.
How the Surgery Is Performed
Once anesthesia is delivered, the goals of LHE remain the same irrespective of whether open, arthroscopic, or percutaneous surgery is used.
LHE follows the following general steps:
Upon completion, your arm is placed in a removable splint that keeps your elbow bent at a 90-degree angle.
Recovery From Tennis Elbow Surgery
Upon returning home, you will need to keep your arm in the sling for seven to 10 days. While sitting or resting, keep the arm in an elevated position to ease the pain.Ice therapycan also help.
Long-Term Care and Rehabilitation
Recovery from tennis elbow surgery can take time. Even before the splint is removed, you will need to start passive rehabilitation exercises, such as arm and shoulder stretches.
Once the splint is no longer needed, extensive rehabilitation may be needed from aphysical therapist. This can help you regain pre-treatment strength andrange of motion.
Physical therapy treatments may include:
Timeline for RecoveryBarring complications, you should be able to return to daily activities in about two to six weeks, return to work in three to 12 weeks, and play sports again without harm in four to six months.
Timeline for Recovery
Barring complications, you should be able to return to daily activities in about two to six weeks, return to work in three to 12 weeks, and play sports again without harm in four to six months.
Risks of Surgery for Tennis Elbow
As with all surgeries, tennis elbow surgery poses certain risks. This is because the operation takes place around delicate structures that are vulnerable to postoperative injury.
Possible risks of LHE include:
With that said, the risk of complications is low. According to a 2016 review of studies published inOrthopedic Clinics of North America,the rates of complications for open, arthroscopic, or percutaneous LHE are 1.1%, 0%, and 1.2%, respectively.
10 Ways to Improve Your Recovery From Surgery
Summary
A lateral humeral epicondylectomy (LHE) is a surgery for people with tennis elbow. It is used when all other conservative options have failed. Relief is provided when a tendon in the outer elbow is released (severed).
The surgery is performed on an outpatient basis and takes less than an hour. Recovery can take up to 12 weeks with a full return to sports in four to six months. Postoperative complications like infection or tendon rupture are rare but can occur.
Other Possible Causes of Elbow Pain
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopedic Surgeons.Tennis elbow (lateral epicondylitis).Weber C, Thai V, Neuheuser K, Groover K, Christ O.Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.BMC Musculoskelet Disord.2015;16:223. doi:10.1186/s12891-015-0665-4Lai WC, Erickson BJ, Mlynarek RA, Wang D.Chronic lateral epicondylitis: challenges and solutions.Open Access J Sports Med.2018;9:243-51. doi:10.2147/OAJSM.S160974Vaquero-Picado A, Barco R, Antuña SA.Lateral epicondylitis of the elbow.EFORT Open Rev.2016;1(11):391-7. doi:10.1302/2058-5241.1.000049Burn MB, Mitchell RJ, Liberman SR, Lintner DM, Harris JD, Mcculloch PC.Open, arthroscopic, and percutaneous surgical treatment of lateral epicondylitis: a systematic review.Hand (N Y).2018;13(3):264-74. doi:10.1177/1558944717701244Amroodi MN, Mahmuudi A, Salariyeh M, Amiri A.Surgical treatment of tennis elbow; minimal incision technique.Arch Bone Jt Surg. 2016;4(4):366-70.Pomerantz ML.Complications of lateral epicondylar release.Orthop Clin North Am. 2016;47(2):445-69. doi:10.1016/j.ocl.2015.10.002
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopedic Surgeons.Tennis elbow (lateral epicondylitis).Weber C, Thai V, Neuheuser K, Groover K, Christ O.Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.BMC Musculoskelet Disord.2015;16:223. doi:10.1186/s12891-015-0665-4Lai WC, Erickson BJ, Mlynarek RA, Wang D.Chronic lateral epicondylitis: challenges and solutions.Open Access J Sports Med.2018;9:243-51. doi:10.2147/OAJSM.S160974Vaquero-Picado A, Barco R, Antuña SA.Lateral epicondylitis of the elbow.EFORT Open Rev.2016;1(11):391-7. doi:10.1302/2058-5241.1.000049Burn MB, Mitchell RJ, Liberman SR, Lintner DM, Harris JD, Mcculloch PC.Open, arthroscopic, and percutaneous surgical treatment of lateral epicondylitis: a systematic review.Hand (N Y).2018;13(3):264-74. doi:10.1177/1558944717701244Amroodi MN, Mahmuudi A, Salariyeh M, Amiri A.Surgical treatment of tennis elbow; minimal incision technique.Arch Bone Jt Surg. 2016;4(4):366-70.Pomerantz ML.Complications of lateral epicondylar release.Orthop Clin North Am. 2016;47(2):445-69. doi:10.1016/j.ocl.2015.10.002
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Orthopedic Surgeons.Tennis elbow (lateral epicondylitis).Weber C, Thai V, Neuheuser K, Groover K, Christ O.Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.BMC Musculoskelet Disord.2015;16:223. doi:10.1186/s12891-015-0665-4Lai WC, Erickson BJ, Mlynarek RA, Wang D.Chronic lateral epicondylitis: challenges and solutions.Open Access J Sports Med.2018;9:243-51. doi:10.2147/OAJSM.S160974Vaquero-Picado A, Barco R, Antuña SA.Lateral epicondylitis of the elbow.EFORT Open Rev.2016;1(11):391-7. doi:10.1302/2058-5241.1.000049Burn MB, Mitchell RJ, Liberman SR, Lintner DM, Harris JD, Mcculloch PC.Open, arthroscopic, and percutaneous surgical treatment of lateral epicondylitis: a systematic review.Hand (N Y).2018;13(3):264-74. doi:10.1177/1558944717701244Amroodi MN, Mahmuudi A, Salariyeh M, Amiri A.Surgical treatment of tennis elbow; minimal incision technique.Arch Bone Jt Surg. 2016;4(4):366-70.Pomerantz ML.Complications of lateral epicondylar release.Orthop Clin North Am. 2016;47(2):445-69. doi:10.1016/j.ocl.2015.10.002
American Academy of Orthopedic Surgeons.Tennis elbow (lateral epicondylitis).
Weber C, Thai V, Neuheuser K, Groover K, Christ O.Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.BMC Musculoskelet Disord.2015;16:223. doi:10.1186/s12891-015-0665-4
Lai WC, Erickson BJ, Mlynarek RA, Wang D.Chronic lateral epicondylitis: challenges and solutions.Open Access J Sports Med.2018;9:243-51. doi:10.2147/OAJSM.S160974
Vaquero-Picado A, Barco R, Antuña SA.Lateral epicondylitis of the elbow.EFORT Open Rev.2016;1(11):391-7. doi:10.1302/2058-5241.1.000049
Burn MB, Mitchell RJ, Liberman SR, Lintner DM, Harris JD, Mcculloch PC.Open, arthroscopic, and percutaneous surgical treatment of lateral epicondylitis: a systematic review.Hand (N Y).2018;13(3):264-74. doi:10.1177/1558944717701244
Amroodi MN, Mahmuudi A, Salariyeh M, Amiri A.Surgical treatment of tennis elbow; minimal incision technique.Arch Bone Jt Surg. 2016;4(4):366-70.
Pomerantz ML.Complications of lateral epicondylar release.Orthop Clin North Am. 2016;47(2):445-69. doi:10.1016/j.ocl.2015.10.002
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