Elbow Release Surgery

 

Elbow release surgery, or more commonly known as tennis elbow release surgery is performed to remove the damaged tendon and ease pain caused by tennis elbow.

 

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What is Tennis Elbow?

Tennis elbow, also known as lateral epicondylitis is a painful inflammation of the elbow joint caused by overuse or certain repeated motions.  Pain is located on the outside side of the elbow, although this can radiate down the back of the forearm.  Pain is most commonly felt when the arm is straightened or fully extended.

 

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What Causes Tennis Elbow?

The tendon is the part of the muscle that attaches to the bone, and forearm tendons attach the forearm muscles to the outer bone of the elbow.  Tennis elbow often occurs when the extensor carpi radialis brevis (ECRB), a specific muscle in the forearm is damaged.  The ECRB helps extend the wrist.

 

Repetitive use weakens the ECRB muscle, causing tiny tear in the muscle’s tendon at the point where it attaches to the outside of the elbow.  The tears can put stress on the rest of the arm, resulting in pain and inflammation, and making it difficult to grip and lift objects.

 

The inflammation is caused by repeated strain of a muscle called the extensor carpi radialis brevis (ECRB).  Contrary to popular belief, it is not limited to tennis players and only causes about 5% of cases. It can affect anyone whose work or activities may strain the ECRB, such as:

 

• Golfing
• Swimming
• Racquet sports
• Painting and plumbing
• Using hand tools such as a screwdriver, chainsaw or hammer
• Computer use
• Playing certain musical instruments
• Carpentry
• Working on cars
• A direct blow to the elbow can cause it to swell

 

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Symptoms of Tennis Elbow

Symptoms of tennis elbow can develop over time, from a mild ache on the outside of the elbow to a constant pain of the elbow that is too painful to touch.  This usually occurs from a matter of weeks to months if treatment is not given.  You may experience some or all of the following symptoms:

 

• A weak grip
• Increased pain when shaking hands or squeezing an object
• Pain when lifting something
• Opening jar

 

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Diagnosis of Tennis Elbow

Your doctor will take a full medical history, asking questions about your job role, if you play any particular sports, when you first noticed symptoms and your level of pain.  A physical examination will be carried out where your doctor will perform some simple tests to help make a diagnosis.  This will include applying some pressure to the area of the tendon that attaches to the bone to check for any pain.  When the elbow and the wrist is bent toward the palm side, you will feel pain on the outer side of the elbow as the wrist is extended.

 

Although not necessary, your doctor may refer you for imaging tests such as an MRI scan or X-ray as this will rule out other disorders that can cause arm pain, including arthritis of the elbow.

 

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Treatment of Tennis Elbow

Approximately 80-95% of cases can be treated with conservative (non-surgical) treatments. These include:

 

Rest

Resting the arm for several weeks is the first step to recovery. You may be given a brace to help immobilise the affected muscles.

Cold compress

Ice packs can be effective in reducing inflammation and relieving pain. You can wrap a bag of peas in a cloth and place directly over the affected area, or use a cold pack that you can buy from your local pharmacy.

Anti-inflammatory medication

Over the counter painkillers such ibuprofen or aspirin can help reduce pain and swelling.

Steroid injections

If you are not getting much pain relief from over the counter remedies, your doctor may recommend a cortisone (steroid) injection directly into the affected muscle to reduce inflammation.  These can be very effective, although a maximum number of 4 per year are recommended as otherwise this can result in weakened muscles.

Physical therapy

A physiotherapist will prescribe exercises to strengthen the muscles of the forearm to promote healing.

Ultrasound therapy

An ultrasound probe is placed over the painful area on the arm and emits high-frequency sound waves into the tissues for a set period of time.  This type of treatment can help reduce inflammation and promote healing.

 

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Surgery

If conservative treatments are not providing you with adequate pain relief, your doctor will discuss the option of surgery with you.

 

The common aspect of surgery is to perform two tasks; to remove the damaged tissue and reattach health muscle to the bone, thus stimulating the healing response in the affected area.

 

Surgery is either preformed arthroscopically (keyhole surgery) or with open surgery where a larger incision is made directly over the elbow.

 

If your procedure is carried with keyhole surgery, a small camera (arthroscope) is placed into the elbow joint through a small incision in the skin, allowing the surgeon to see inside.  The damaged tendon is then removed without detachment of the tendon from the bone.  Although arthroscopic surgery for tennis elbow is fairly new, early results are encouraging with high rates of success.

 

Open surgery is the most common surgical approach for tennis elbow.  Once the incision has been made, the location of the tendon damage is identified and this part of the tendon is removed.  The underlying bone is exposed and blood flow to this area is stimulated.  The remaining tendon can be repaired by using sutures (stitches) anchored into the bone.  The incision is then closed and dressed.

 

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Post-Operative Recovery

Once your surgery is complete, your arm will be immobilised with a splint which you will need to wear for approximately one week to allow the incision to heal.  Once the splint and stitches have been removed, you will begin physical therapy to help improve range of motion, restore muscle strength, and flexibility.

 

Elbow release surgery is generally carried out as a day case procedure so you will be able to go home the same day, provided there are no complications.  You will need someone to drive you home and stay with you for the first few days following your procedure.

 

For the first few 2-6 weeks you will focus on light exercises to improve flexibility, after which you will begin strengthening the arm.  You can resume more strenuous activities approximately 12 weeks after your surgery, although this will vary from patient to patient.  Your doctor will recommend the appropriate length of time for you.

 

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Risks and Complications

Although elbow release surgery is considered a safe procedure, as with all invasive surgery, there are associated risks. These include:

 

• Infection at the wound site
• Bleeding
• Stiffness of the elbow
• Swelling of nerve tissue
• Weakness of the wrist
• Partial symptom relief
• Regional pain

 

If you experience any of the below signs, call your doctor immediately:

 

• Severe pain
• Numbness or tingling in your hands or finger
• Pus oozing from the wound
• Fever or chills
• Swelling that doesn’t go away
• Redness or other skin colour changes around your elbow

 

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Outlook after Elbow Release Surgery

Elbow release surgery is generally considered a successful treatment for tennis elbow in 80-90% of cases, although it is common to experience some loss in muscle strength.  Those who still experience persistent pain after surgery should consider having further investigations for other potential causes of elbow pain to determine if there could be another source to their symptoms.

 

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Need Help?

At One Ashford Hospital we can book you in to see a specialist Consultant Orthopaedic Shoulder and Elbow Surgeon, usually within 48 hours, for an initial consultation.  One Ashford Hospital is well placed to see patients with knee injuries from Ashford, Maidstone, Canterbury, Folkestone, Dover and all surrounding villages.  To book an appointment, call the hospital direct on 01233 364 022 or email here

 

You can use your private medical insurance or pay for your Elbow Release Surgery treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Ashford Hospital

Why One Ashford Hospital

• Access to leading Consultants within 48 hours*
• 0% and low finance options**
• Competitive fixed-price packages
• Modern purpose-built hospital
• Private, spacious, ensuite rooms
• Specialist Physiotherapy and nursing teams
• Little waiting time for surgery
• Calm, dignified experience

*Dependent on Consultant availability
**Terms and conditions apply

Contact us and find out more

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