What is tennis elbow?

Tennis elbow is caused by wear and tear of the tendons on the outside of your elbow, causing pain, stiffness and, sometimes, weakness.

What are the benefits of surgery?

9 in 10 people heal within a year without surgery. The main benefit of surgery is to get relief from the symptoms more quickly.

Are there any alternatives to surgery?

Resting your elbow when you have symptoms and not doing the activities that cause pain will treat the condition but it can take up to 2 years to recover fully.

Physiotherapy can help you to recover more quickly.

Some people may also benefit from wearing a splint.

A steroid injection into your elbow joint can sometimes reduce pain and stiffness for several months.

Injections of blood, taken from a vein in your arm and injected into your elbow, are more effective than other types of injection.

Sometimes an injection of hyaluronic acid can improve symptoms.

What will happen if I decide not to have the operation?

Rest your elbow and do not do the activities that cause your symptoms. Your surgeon or the physiotherapist may recommend that you continue with another treatment.

What does the operation involve?

Keyhole surgery is usually performed under a general anaesthetic but sometimes a nerve block is used. The open operation can be performed under a local anaesthetic.

The operation usually takes about 30 minutes.

Keyhole surgery

Your surgeon will usually make two small cuts, about half a centimetre long, around the joint. They will insert a small telescope through one of the cuts so they can examine the joint. They will insert surgical instruments through the other cut to remove the damaged part of the tendon and to treat any other problems with the joint.

Open surgery

The operation is similar but is performed through a 4 to 5 centimetre cut made on the outside of your elbow.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Bleeding into the joint. This causes swelling and pain.
• Infection in your elbow joint.
• Severe pain, stiffness and loss of use of your arm and hand. Your arm and hand can take months or years to improve. Sometimes there is permanent pain and stiffness.
• Damage to nerves around the joint, leading to weakness, numbness or pain. This usually gets better but may be permanent.
• Nerve damage. These nerves pass close to your elbow and can become bruised, leading to weakness in your hand. This usually gets better but in rare cases may be permanent.
• Continuing symptoms.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day.

The physiotherapist or occupational therapist may give you exercises and advice to help you to recover from the operation.

It can take a few weeks to get back to normal activities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people have a major improvement and a quicker return to normal activities.

Summary

Tennis elbow is caused by wear and tear of the tendons on the outside of your elbow. The main benefit of surgery is to get relief from the symptoms more quickly.

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