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Tennis Elbow
WHAT IS TENNIS ELBOW?
Tennis Elbow is a degenerative condition of the tendons that attach to the
bony prominence (Epicondyle) of the outside of the elbow. These tendons
are responsible for anchoring the muscles that extend and lift the hand.
The symptoms of Tennis Elbow are mild to severe burning pain on the
outside part of the elbow, which may become worse by pressing on the
outside of the elbow, by gripping and lifting objects or by simply moving the
elbow joint.
WHY DOES TENNIS ELBOW OCCUR?
Tennis Elbow usually occurs in patients between the ages of 30 to 50
years, especially in patients with occupations involving repetitive movement
of the elbow, regular athletics or racket sports. Occasionally patients
develop Tennis Elbow without any specific recognisable activity leading to
symptoms.
HOW IS TENNIS ELBOW TREATED WITHOUT SURGERY?
The use of regular anti-inflammatory medications, ice packs and enforced
rest of the affected elbow joint for several months can usually successfully
alleviate this condition. An orthotic brace to apply a counterforce or/and
splint the wrist may be useful to aid this enforced rest. If symptoms fail to
improve over six weeks the next step is usually to inject a steroid solution
around the outside of the elbow, which will reduce pain and inflammation.
A combination of conservative treatment and steroid injection is usually
successful in around 85% of cases.
HOW IS TENNIS ELBOW TREATED WITH SURGERY?
Surgery to resolve Tennis Elbow is typically avoided for all but the more
severe and debilitating cases and those that have failed to respond to
conservative treatment. Surgical intervention is aimed at removing diseased
tendon tissue and reattaching normal tendon tissue to bone. Surgery is
typically carried out as a day case and can be performed under general
anaesthetic (you will be asleep) or under regional anaesthetic (you will be
awake). The procedure usually takes around 30 to 40 minutes to perform
dependant on the severity of the diseased tendon. The surgeon will either
perform this procedure through a small incision over the bony prominence
on the outside of the elbow or through a small keyhole. Keyhole surgery is
also known as Arthroscopic Surgery -please see separate fact sheet on
this procedure for further details.
WHAT IS THE RECOVERY AFTER SURGERY LIKE?
Once a patient is fully recovered from the effects of anaesthetic they are
normally quickly encouraged to be as active and mobile as possible to
avoid joint stiffness and other complications such as Deep Vein
Thrombosis (DVT) from developing. It is therefore normal for patients to
be encouraged to take a short walk and perform gentle postoperative
exercises with guidance from a physiotherapist on the day of surgery.
Following a progressive improvement of mobility and pain control patients
are normally discharged from hospital on the day of surgery. By the time
the required level of recovery is achieved for discharge, patients are
normally fully mobile, wearing a light weight dressing and support splint on
the effected elbow joint, eating and drinking normally and taking only mild
analgesia (pain killers). Over the next six weeks patients will be expected
to work on improving their new elbow joints mobility and stability through a
dedicated and progressive upper limb physiotherapy regime. Your
Consultant Orthopaedic Surgeon will assess your joints stability and range
of movement after six weeks and then again after three months to evaluate
how successful your elbow procedure has been. Patients should expect a
continuous and full physical recovery to take around four to six months to
achieve.
ARE THERE ANY RISKS ASSOCIATED WITH TENNIS ELBOW SURGERY?
Corrective surgery of this type is considered a specialist procedure to
perform successfully. It is therefore very important that all candidates are
fully aware of both the benefits and risks of undertaking such surgery. The
importance of a full consultation to discuss your condition with a specialist
upper limb orthopaedic surgeon in relation to these risks cannot therefore
be over emphasised.
HOW DO I FIND OUT IF I AM A SUITABLE CANDIDATE FOR TENNIS ELBOW SURGEY OF THIS TYPE?
At NW Specialist Classic Hospital's our Consultant Orthopaedic Surgeons
will carry out a full evaluation of your individual symptoms and
circumstances and provide you with a comprehensive verbal and written
explanation of your condition, recommending the most appropriate solution
to improve your condition.
Our specialist Consultant Orthopaedic Surgeons
understand the importance of the decision you are making when
contemplating corrective surgery of this type. Throughout your consultation
you will be encouraged to ask as many questions as you wish and to take
your time in making a decision to proceed with any recommended
treatment.
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