Tennis Elbow Meets Its Match
Tennis elbow can be caused by injury or overuse of the tendons that attach on the outside of the elbow. The body tries to heal the microscopic tears that form in the tendon. Eventually, scar tissue builds up where the tendon meets the outer bump of the elbow, the lateral epicondyle. The condition causes soreness along the outside of the elbow.
Five to ten percent of patients with tennis elbow don't respond to conservative treatment. These patients may need surgery to get relief from their symptoms. There are a few ways to go about this surgery. Doctors can do an "open procedure," meaning they make a large incision in the skin. Or they can operate through the skin using an arthroscope. An arthroscope is a a miniature camera that lets the doctor watch the procedure on a television. This "closed" procedure may reduce some of the risks of the open procedure. But does it get rid of patients' symptoms?
This study reported on the results of arthroscopy for 16 patients with tennis elbow. All of the patients had tried at least six months of conservative treatment, including cortisone injections, before having surgery. Three-quarters were men. Their average age was 50 years old. Most of the patients had desk jobs. All of them described themselves as recreational athletes.
Doctors used the arthroscope to get in and remove the unhealthy tissue on patients' elbows. The lesions causing the tennis elbow were of different types and levels of seriousness. Three patients were also found to have other problems associated with tennis elbow.
Twelve of the patients were followed-up for two years. None of the patients had any complications from surgery, and none needed to have further surgery for their symptoms.
Patients were able to resume their normal activities soon after surgery. Notably, they were back to work with no restrictions in an average of only six days. They were all able to return to sports, except one 70-year-old patient whose symptoms had lasted for 20 years.
Patients were very satisfied with the arthroscopic procedure. Ten patients (83 percent) said they felt much better as a result of surgery. No patients said they felt the same or worse after surgery.
Arthroscopy allows doctors to remove unhealthy tissues without hurting the healthy tissues nearby. And it allows doctors to identify other problems that may be adding to patients' elbow symptoms. All in all, arthroscopy appears to be a safe, reliable way to beat tennis elbow.
Brett D. Owens, MD, et al. Arthroscopic Release for Lateral Epicondylitis. In Arthroscopy. July-August 2001. Vol. 17. No. 6. Pp. 582-587.