What is tennis elbow surgery?

Surgery for tennis elbow takes out damaged parts of tendons from the elbow. Your doctor may also reattach healthy tendon to the bone. Tendons connect muscle to bone.

Your doctor will make one small cut, called an incision, over the bony area on the outside of your elbow. He or she will then take out the damaged part of the tendon. Your doctor will close the incision with stitches or staples. The incision will leave a scar that usually fades over time.

After surgery, you may go through a rehabilitation program (rehab). After rehab, you will probably be able to use your elbow and arm without pain. You probably will be able to return to normal activities, such as playing tennis and other sports.

You will go home on the day of the surgery. You should be able to return to daily activities in about 2 to 6 weeks. How soon you can go back to work depends on your job. You should be able to play sports again in 4 to 6 months. You may need a brace at work. You also may need a brace when you play sports that stress the elbow and forearm, such as tennis.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• You may shower 24 to 48 hours after surgery, if your doctor okays it. Keep your bandage dry by covering it with plastic. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when you can drive again.
• You will be able to return to daily activities in about 3 to 6 weeks and go back to work in 6 to 12 weeks, depending on your job.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the cut (incision), leave the tape on for a week or until it falls off.
• If you have a bandage, keep it on until the incision heals. You may change it if it gets dirty.

Exercise

• Elbow and arm rehabilitation is a series of exercises you do after your surgery. This helps you get back your elbow's and arm's range of motion and strength. You will work with your doctor and physical therapist to plan this exercise program. To get the best results, you need to do the exercises correctly and as often and as long as your doctor tells you.

Ice and elevation

• Put ice or a cold pack on your elbow for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
• Prop up the sore elbow on a pillow when you ice it or anytime you sit or lie down during the next 3 days. Try to keep it above the level of your heart. This will help reduce swelling.

Other instructions

• To prevent tennis elbow from returning, you may have to adjust your tennis racquet's size and string tightness, and your grip.
• Start slowly with activities that use repeated movement. If your elbow or arm starts to hurt, stop and rest.

Various surgical procedures are used to treat tennis elbow. Some surgical research exists. But there are no published, controlled trials that either strongly support or discourage the use of any one procedure or prove that surgery is better than other treatment.

Most people are able to return to their previous activities after tennis elbow surgery. Be sure to change any previous technique, equipment, or activity that has been linked to the elbow pain.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

The risks of surgery for tennis elbow include:

• Slight loss of ability to straighten the arm.
• Elbow pain that won't go away or that comes back.
• Infection, blood loss, nerve damage (risks in all surgeries).
• Anesthesia side effects.

Recovery varies from person to person. It usually takes at least 3 to 6 months to recover completely.

• Cigarette smoking slows tendon and wound healing.
• Recovery depends on the amount of time and effort you put into a rehabilitation program.
• You may not be able to keep doing the activity that caused your tennis elbow. Or you may have to make some changes to the way you do that activity from now on.

You will have some pain. Your doctor can give you medicine for this. A large bandage will cover your stitches (sutures). Your arm may be in a splint or a cast. These are all removed in about 7 to 10 days. You may have a smaller splint for about 2 weeks. You will not be able to use your arm during this time. You will need help doing anything that usually takes two hands.

You will need a rehabilitation program (rehab) that includes exercises to stretch and strengthen the elbow. Your doctor will advise you when to do gentle range-of-motion or gripping exercises after surgery. You will first have training and help, and then you will do the program on your own. Your exercises may be painful at first. In 3 to 6 months, the pain should go away, and you should have good movement in your elbow. You may need to do strength exercises for as long as 1 year.

You will be able to return to daily activities in about 2 to 6 weeks. You can go back to work in 3 to 12 weeks, depending on your job. You should be able to play sports again in 4 to 6 months. You may need a brace at work and when you play sports that stress the elbow and forearm, such as tennis.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 45 minutes.

You and your doctor may consider surgery if:

• You still have elbow soreness and pain after more than 6 to 12 months of nonsurgical treatment.
• You can't do your daily tasks and activities because of elbow pain.