Deciding If Tennis Elbow Surgery is Right for You

When is Tennis Elbow Surgery Performed?
First of all, keep in mind that tennis elbow surgery is the treatment of LAST RESORT.

However you may still have the question, “What if my pain becomes unbearable?” or “What if my condition is deteriorating?” or “What if my arm is simply not getting better?”

There are very few cases of tennis elbow that require surgery. So with very few exceptions and regardless of the severity of your pain, your medical team will require that you undergo the standard, conservative treatment for six months or more before deciding on surgery.

What is involved in the Surgery?
If your arm requires surgery, your surgeon will need to make a number of critical decisions. The first conce
in the actual surgery is what kind of incision to make. Can the surgeon get by with a small, short arthroscopy incision, or will the incision using a scalpel and retractors be better for your arm.

In arthroscopic surgery, a short, 1/2 inch incision is made, into which a flexible cable the diameter of a drinking straw is inserted. At the end of this cable, which goes inside the arm, a tiny camera has been mounted. There might also be at least one other instrument attached to this cable.

Fluid is pumped into the arm's cavity, where the arthroscope was inserted, to dilate the cavity so there is room for the camera to see. This fluid is also used to anesthetize the tissues in the arm.

In the surgery, there is typically another small incision made into which at least one other instrument is inserted, usually for cutting and sewing.

The small incisions of arthroscopic surgery allow for a lower incidence of infection and they promote faster healing. And of course, there is less scarring.

In tennis elbow surgery, the surgeon needs to cut away portions of the tendon and/or muscle. This is usually done by removing the end of the tendon from the bone, then cutting off the short affected portion of the tendon, then reattaching it to the bone. The surgery may also require cutting away some defective muscle tissue. And it's possible that the surgeon must “sand down” any portion of the bone that is irritating the tendon or muscle.

What are the Risks?
The invasiveness of surgery automatically entails risks. One such risk is that you may never be able to fully extend your arm. And although anesthesiology is not as big a risk as it used to be, it still presents some risk. Nerve damage is a possible risk. And there is a risk that the arm may be weaker. And do remember that surgeons sometimes make mistakes.

Your surgeon may employ two devices that could make the surgery more precise. One of those is the use of a laser, which can be used to cut away tendon and diseased muscle tissue as well as to cauterize the bleeding.

The other device that the surgeon may use is a robot. The robot moves the surgical instruments in the smallest fractions of an inch and they can rotate the instruments 360°. One of the biggest advantages in using the robot is that it is not subject to the shaking or jerking that a surgeon's hand might undergo when the surgeon is fatigued.