There still remains much about the treatment of chronic epicondylitis (tennis elbow) that we just don't know. Conservative (nonoperative) care is always recommended first. Patients are encouraged to try a variety of treatments from medications to acupuncture to physical therapy before considering surgery.
When operative management is indicated, the surgeon may use a percutaneous (through the skin) or an open incision technique. Arthroscopic or endoscopic methods are also available. In these approaches, the surgeon inserts a long, thin needle or tube into the area. A tiny TV camera at the end of the needle or threaded down the tube allows the surgeon to see into the area. Open incision is still used in some cases.
The surgeon may release some or all of the soft tissues along the lateral (outside of the) elbow. This may include the extensor carpi radialis brevis (ECRB) tendon, joint capsule, or debridement of any visible pathologic tissue. Debridement refers to removal of the tissue. A small, motorized shaver may be used to gently remove the diseased tissue.
Studies show good to excellent short-term results with any of these operative techniques for lateral epicondylitis. There isn't enough scientific evidence to support one method over another. Some studies also report a high rate of satisfactory results on a long-term basis. Pain was relieved and function was improved. Patients were often able to return to their previous level of work or play. Only a small number of patients had to change jobs because of continued elbow pain and dysfunction.