Arthroscopic Surgery For Tennis Elbow : Procedure & Aftercare

How is a Tennis Elbow Treated?

Tennis elbow usually gets better on its own. Your doctor may suggest self-care measures and physiotherapy for better management. Surgery is advised in severe cases. The treatment for tennis elbow involves the following-

• RICE Protocol: This is the first line of treatment for tennis elbow. It involves Rest, Ice, Compression, and Elevation of the affected joint. 
• Pain management: You may be prescribed over-the-counter pain medications to manage pain.
• Physiotherapy: You may be referred to a physiotherapist for your tennis elbow. Physiotherapists teach exercises to stretch and strengthen your muscles, especially the forearm. They will also examine your activities and suggest changes to reduce the pressure on your elbow.
• Injections: You may be suggested to get injections of platelet-rich plasma or Botox into your elbow joint. This quickens the healing of the injured tendons.
• TENEX (ultrasonic tenotomy): This is a procedure to help the injured tendon to heal faster. The surgeon inserts a special needle into the damaged tendon, and using ultrasonic energy, the needle is vibrated swiftly, causing the damaged portion of the tendon to liquefy. The liquified portion is then suctioned out.
• Surgery: Surgery will be advised if your condition fails to resolve even after 6 to 12 months of non-invasive treatment. Surgical options include the traditional open surgery or an arthroscopic surgery performed via an arthroscope (a small instrument that helps the surgeon to look inside your joint)

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin! 

What are the Benefits and Risks of the Procedure?

Arthroscopic surgery for tennis elbow is a minimally invasive procedure with a quicker recovery time and higher success rate than open surgery. However, it also carries certain risks you should know before opting for it.

Benefits of arthroscopic surgery for tennis elbow

• Quick procedure
• Minimally invasive, only 32 to 3 small incisions are made
• Can address other issues with the elbow joint that may not have been visible on the imaging tests
• Faster recovery
• A better range of motion and muscle strength is seen post-surgery than open surgery.

Risks of arthroscopic surgery for tennis elbow

• Nerve injury- The nerves in the region may get damaged during the procedure leading to temporary numbness
• Pain- There may be pain for several weeks after the procedure. You must take the pain medications regularly.
• Stiffness- The joint and muscles may become stiff, and you may lose the motion and mobility of the joint considerably. This can be prevented by following the physiotherapist’s instructions diligently.
• Infections- Arthroscopic surgery on the elbow has a higher infection rate than similar procedures performed on the knee or shoulder.
• Blood clots- There is a risk of developing blood clots post-surgery. These can be dangerous if they travel and get lodged in the heart or lungs.

What to Expect After an Arthroscopic Surgery for Tennis Elbow?

Once the procedure is completed, you will be shifted to a recovery room where your vital parameters, i.e., your temperature, pulse, respiratory rate, and blood pressure, are monitored. You can go home once the vitals are normal and the effects of anesthesia have worn off. 
During discharge, you will be explained in detail about caring for the operated joint at home. A physiotherapist will also meet you and guide you on the exercises to restore motion and strength in the operated joint and muscles.

Here is what you can do at home to heal better-

• You will have pain for several weeks after the surgery. Remember to take the prescribed medications on time.
• Apply ice packs on the joint regularly for 48 hours after surgery. This helps to reduce the pain and swelling.
• Keep your elbow elevated at all times.
• Keep moving your fingers and wrists gently and regularly for as long as you can bear the pain.
• The dressing on the wound must be kept dry at all times. Once the post-operative visit is completed and the dressing is removed, ensure that the operated area is always dry and clean.
• Follow-up visits at the physiotherapist’s office are very important. The exercises suggested playing a crucial process in regaining elbow and forearm motion. They also improve the strength of the muscles weakened after the surgery.
• You can get back to work and start driving after 2 weeks. 
• Strenuous exercises, lifting heavy objects, and pre-operative repetitive activities of the elbow are best avoided for a minimum of 12 weeks.
• Complete recovery takes 6 to 8 weeks.

How is an Arthroscopic Surgery for Tennis Elbow Performed?

Arthroscopic surgery for tennis elbow is performed under general anesthesia and takes about 30 minutes to complete. Here is what happens to you during the surgery.

During the Surgery

• An IV line will be set up for administering fluids and antibiotics.
• You will be given general anesthesia to put you to sleep during the surgery.
• The surgical area is cleaned and disinfected. The sites of the incisions are marked.
• The surgeon uses a scalpel to make incisions on the areas marked. Generally, 2 to 3 incisions of not more than 5 mm are made on either side of the elbow joint.
• The arthroscope is inserted through the incision on the outer side of the joint. Small instruments used during surgery, like forceps, are inserted through the other incisions.
• The elbow joint is filled with saline and passed through the arthroscope. The saline helps for distending and better visibility of the joint.
• The surgeon performs a complete evaluation of the joint.
• The ECRB tendon (extensor carpi radialis brevis muscle tendon responsible for wrist movement) is released from its origin on the bone.
• Loose bodies, such as pieces of damaged bone, degenerated tendons or muscle tissue, etc., are removed.
• The incisions are closed.
• The wound is dressed. Your surgeon may put your joint in a splint to restrict movement or add a soft dressing to protect the elbow.

How to Prepare for an Arthroscopic Surgery for Tennis Elbow?

Arthroscopic surgery for tennis elbow is a minimally invasive procedure done under general anesthesia. Here is how you can prepare for the surgery.

Before the surgery:

• Discuss your medical history with your surgeon and inform him about:-
  • All the medications that you are currently taking for your health conditions
  • Any dietary supplements and herbs that you are taking
  • Allergies towards medicines.
• You can ask your surgeon to explain the procedure's details, outcome, and prognosis. You will be asked to sign an informed consent form agreeing to proceed with the surgery.
• You will be asked to stop medications like blood thinners (to prevent excessive bleeding during and after surgery) a week before surgery.
• You will be advised to take certain tests. These include-
  -Routine blood and urine tests
  -An X-ray 
  -Imaging Tests like CT Scans and MRIs that give high-resolution images of the joint
• You will be asked not to eat or drink anything from 6 hours before the surgery.
• Arrange for someone to drive you home after the surgery. Also, take time off from work for a minimum of 3 weeks.

When is Arthroscopic Surgery for Tennis Elbow Recommended?

Arthroscopic surgery for tennis elbow is a minimally invasive procedure to relieve the symptoms. It is preferred over open surgery because of the faster recovery and less pain. It is indicated in the following conditions.

• Athletes and other sportspersons who use their arms in repetitive motion, like tennis players, butchers, and painters
• In people with arthritis affecting the elbow
• In people having infections inside the joint
• Presence of loose bodies in the joint as a result of trauma, age-related degeneration
• Release of scar tissue to improve range of motion
• As part of the treatment of osteoarthritis (age-related degeneration of the joints) and rheumatoid arthritis (an autoimmune condition of the joint where the body attacks its cells)
• No response to more than 6 to 12 months of non-invasive treatment for tennis elbow

What is an Arthroscopic Surgery for Tennis Elbow?

Arthroscopic surgery for tennis elbow is a minimally invasive procedure that relieves the symptoms of tennis elbow. The procedure involves making small incisions of 5mm on either side of your elbow. These incisions are used for inserting the arthroscope and small instruments required during the surgery. The surgeon can visualize the inside of your elbow joint through the arthroscope and release the affected tendon. The arthroscope also allows the surgeon to visualize other problem areas that may have been missed during the diagnostic imaging tests.
This surgery is performed under general anesthesia. It will take about 8 to 16 weeks for complete recovery.

Arthroscopic surgery allows precise correction of the condition without affecting other nearby tendons. It involves making smaller incisions as compared to open surgery. The pain and recovery period also show significant differences from open surgery.

What is Meant by a Tennis Elbow

Tennis elbow is a condition that occurs due to overuse of the arms and wrists, causing excessive strain on the elbow joint. Apart from tennis players, it can also be seen in plumbers, carpenters, painters, butchers, and people who lift heavy weights. 
The pain appears primarily on the lateral epicondyle (the bony prominence you feel at your elbow). This is where the tendons of all arm muscles are inserted. 
If you have tennis elbow, you may be unable to hold a coffee cup, turn a doorknob, shake hands with a friend, or have a firm grip. 
In most cases, the symptoms subside by resting the affected joint. Applying ice packs, keeping the elbow elevated, and pain medications are beneficial too. Your doctor will advise you to seek help from a physiotherapist to help heal the injured joint. Surgery is advised only in severe cases of tennis elbow. Surgical options include the traditional open surgery or an arthroscopic surgery performed via an arthroscope (a small instrument that helps the surgeon look inside your joint)

Overview

Tennis elbow is a painful condition that occurs when the tendons of your elbow joint are overworked with the repeated movement of the arms and wrists. The condition is known as Tennis Elbow because it is frequently seen in tennis players. Rest, ice packs, elevation, and over-the-counter pain medications are usually enough to treat tennis elbow. In severe cases, you may be suggested surgery. The surgery for tennis elbow can be done as an open procedure or arthroscopically, which involves making small incisions and visualizing the inside through an arthroscope (a small instrument that helps the surgeon look inside your joint).