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Home > Centers of Excellence > Orthopedic > Release Lateral Epicondyle 

What is Release Lateral Epicondyle?

A lateral epicondyle release is a common surgery for tennis elbow.

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Effects of Release Lateral Epicondyle

Surgical treatment of lateral epicondylitis has generated positive results, with roughly 85% of patients reporting total pain relief.

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Candidates for Release Lateral Epicondyle

If conventional treatment is not successful in alleviating pain or helping patients regain use of the elbow, surgery may be needed.

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Your Consultation

Initially, the doctor will obtain a thorough medical history. You will need to answer questions concerning your pain, how your pain affects you, your regular activities, and previous injuries to your elbow. The physical exam is usually the most helpful in diagnosing tennis elbow. Your doctor may position your wrist and arm so you feel a stretch on the forearm muscles and tendons. This is typically painful with tennis elbow. There are also other tests for wrist and forearm strength that can be used to detect tennis elbow. You may be required to get x-rays of your elbow and these can help your doctor rule out other problems with the elbow joint. Also, the x-ray may show if there are calcium deposits on the lateral epicondyle at the connection of the extensor tendon.

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The Release Lateral Epicondyle Procedure

This surgery is generally done as an outpatient, with the use of either general or regional anesthesia. Also, an axillary block may be necessary to numb the arm prior to surgery on the elbow.

This surgery takes tension off the extensor tendon. The surgeon starts by making an incision along the arm over the lateral epicondyle. Then soft tissues are carefully moved to one side so the surgeon can see the point where the extensor tendon connects to the lateral epicondyle. After that, the extensor tendon is cut where it links to the lateral epicondyle. The surgeon separates the tendon and removes any excess scar tissue. Also, any bone spurs seen on the lateral epicondyle are removed. There are some doctors that suture the loose end of the tendon to the nearby fascia tissue. (Fascia tissue covers the muscles and organs throughout your body.) Finally, the skin is stitched together.

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Recovery

In cases where the tendon is inflamed, conservative treatment is typically required for about 3 to 4 weeks. But when symptoms are from tendinosis, anticipate healing to take longer for about 3 months. And if tendinosis is severe, complete healing may take about 6 months.

Rehabilitation though, takes much longer following surgery. After surgery, your elbow is immediately placed in a removable splint that keeps your elbow bent at a ninety-degree angle. During the first few therapy sessions, you may need ice and electrical stimulation treatments to help manage pain and swelling from the surgery. Your therapist may also apply massage and other kinds of hands-on treatments to relieve muscle spasm and pain.

You may need therapy for 2 to 3 months. And it could take 4 to 6 months to get back to high-level sports and work activities. Before your therapy sessions conclude, your therapist will inform you several ways to prevent future problems.

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Risks

The major complications of lateral epicondylitis surgery are weakness of wrist extension and recurrence of symptoms. One of the most troublesome complications of aggressive surgical debridement is lateral elbow instability. The proximity of the lateral collateral ligaments and the annular ligament makes them vulnerable to injury. Additionally, the radial nerve is put at risk when utilizing the arthroscopic technique.

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Frequently Asked Questions

Q: What is lateral epicondylitis?

A: Lateral epicondylitis, or ‘tennis elbow,’ is the pain and discomfort related with inflammation at the extensor muscle group origin at the lateral humeral condyle insertion, primarily in the extensor carpi radialis brevis (ECRB) tendon.

Q: What causes lateral epicondylitis?

A: Lateral epicondylitis is not just restricted to tennis players. It is a fact that the backhand swing in tennis can strain the muscles and tendons of the elbow in such a way that leads to tennis elbow. But various other kinds of repetitive activities can also lead to tennis elbow, such as painting with a brush or roller, running a chain saw, and using many forms of hand tools. Activities that constantly stress the same forearm muscles can produce symptoms of tennis elbow.

Q: What parts of the elbow are affected?

A: Tennis elbow produces pain that sets off on the outside bump of the elbow, the lateral epicondyle. The forearm muscles that bend the wrist back (the extensors) connect on the lateral epicondyle and are linked by a single tendon. Tendons connect muscles to bone and are made up of strands of a material called collagen. The collagen strands are lined up in bundles adjacent to each other.

Q: What does tennis elbow feel like?

A: The primary symptoms of tennis elbow are tenderness and pain that begins at the lateral epicondyle of the elbow. The pain may proliferate down the forearm and may go as far as the back of the middle and ring fingers. The forearm muscles may also become tight and sore. The pain typically gets worse when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow. Also, grasping items makes the pain worse. At times, the elbow feels stiff and would not straighten out totally.

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