Tennis Elbow Procedure
One of the most painful and known conditions is tennis elbow. Anyone can have tennis elbow and their pain presents with weakness and less movement in the muscles of the forearm.
Type of anesthesia during tennis elbow surgery
The procedure may be done under general anesthesia (while you sleep) or with a regional anesthetic (where an area is numbed but you are awake). The anesthesiologist will talk to you and explain all of this.
While you sleep, a tourniquet may be placed on your upper arm. This will limit the amount of blood loss and is important.
Your surgeon will clean your skin with an antiseptic and place sterile cloths (towels) around the area to be operated on. A cut is then made over the problem area where the tendons come from. This is usually a curved cut of no more than 5 - 7 cm.
The point from which the tendons come is removed from the bone (which is then cleaned of any lumps or scar tissue). When finished, the skin is closed with stitches. Some surgeons will use stitches under the skin that will dissolve, others will use stitches above the skin that may or may not dissolve (this should be removed in 10 to 14 days).
Recovery after operation
After surgery performed under general or regional anesthesia, you will have a bandage around your arm. This can be removed in 2 days, but the white sticky cast must be kept on and the wound must be kept clean and dry.
You will most likely need analgesics for the first few days after surgery as the elbow will be sore.
You can start using your arm gently and gradually increase it, however, you should avoid intensive use for 6 weeks. Full recovery may take up to 3 months, plus time for full return to sports.
Risks of Tennis Elbow Surgery
As with all procedures, this carries some risks and complications.
- Pain: The procedure involves moving soft tissue and hurts afterwards. It is important to discuss this with the staff and ask for pain medication if necessary.
- Infection: This may present as redness, discharge, or temperature around the flap or donor site.
- Hypertrophic Keloid Scar: Scars that grow excessively (within the margin of the wound and beyond, respectively).
- Fat necrosis: this is also a cause of delayed wound healing.
- Damage to nerves: There are very few important nerves in this area. Rarely, you may experience numbness around the scar site.
- Posterolateral instability of the elbow: This results from injury to the ligaments (elbow stabilizers). It means that the elbow feels less stable.
- Delayed wound healing: This may occur if the wound is stressed, infected, or has poor blood supply.
- Delayed return to activity: Your recovery may be variable and you may need to stay away from sports/gardening or other strenuous activities for an extended period of time.
- Decreased function: You may never have as much strength, movement, or function as you once had.
There are several non-surgical treatments available. These include reducing inflammation (swelling) by simply supporting the elbow. Using an ice pack and pain relievers (such as ibuprofen) is also helpful at this time.
Your doctor or surgeon may also recommend a physical therapy course: they will teach you exercises to try to strengthen or stretch your forearm muscles or use ultrasound equipment to limit inflammation (swelling). They may also show you how to avoid irritating or straining the tendons.