Lateral epicondylitis surgery
Lateral epicondylitis is tendonitis involving the extensor tendon muscle insertion at the lateral epicondyle (outside part) of the elbow.
The initial treatment consists of anti-inflammatory medication, bracing, physical therapy, exercises, and steroid injection.
Sometimes conservative treatment fails to stop the pain or help patients regain use of the elbow. In these cases, surgery may be necessary.
When problems are caused by tendinosis, doctors may choose to take out only the affected tissues within the tendon. In these cases, the surgeon cleans up the tendon, removing only the damaged tissue.
A commonly used surgery for tennis elbow is called a lateral epicondyle release. This surgery takes tension off the extensor tendon. The surgeon begins by making an incision along the arm over the lateral epicondyle. Soft tissues are gently moved aside so the surgeon can see the point where the extensor tendon attaches on the lateral epicondyle.
The extensor tendon is then cut where it connects to the lateral epicondyle. The surgeon splits the tendon and takes out any extra scar tissue. Any bone spurs found on the lateral epicondyle are removed. Some doctors suture the loose end of the tendon to the nearby fascial tissue. The skin is then sewn together.
This surgery can usually be done as an outpatient. It can be done using a general anesthetic or a regional anesthetic.
Surgery for lateral epicondylitis may be a thing og the past. A new procedure called percutaneous needle tenotomy is more effective and much less invasive with almost no down time. The procedure involves using a small needle to irritate the tendon using ultrasound guidance. Platelet rich plasma obtained from the whole blood of the patient is then injected into the area. Platelet rich plasma contains multiple growth factors that help stimulate regeneration and healing of the tendons.
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