Tennis Anyone? Serving Up a Successful Elbow Surgery

"Tennis elbow," a term first heard in the 1800s, happens in the elbow but doesn't usually have anything to do with tennis. In the medical world, tennis elbow is more accurately called lateral elbow tendonopathy or lateral epicondylitis. The main symptom is pain along the outside of the elbow. Elbow tendonopathy is often seen in the workplace. Work that requires repetitive motion of the arm with high-impact loads is a common cause of this condition.

The pain can occur only in the elbow, or it may travel down the arm to the wrist and hand. At first, pain occurs when the arm is being used. But left untreated, the pain can become constant, even when the arm is at rest. Early treatment with anti-inflammatory medications, rest or work restrictions, and steroid injections helps in 90 percent of all cases. Physical therapy may be advised. Sometimes the patient seeks out a chiropractor for manipulation.

When these methods are unsuccessful, surgery may be recommended. Various surgical methods for lateral elbow tendonopathy have been reported. A method called the V-Y slide has been used with excellent results. In this operation, the tendon on the outside of the elbow is cut and released, and the bone underneath is shaved or smoothed off. The tendon is allowed to slide down about half an inch, where it reattaches.

There are several advantages to this surgery. The joint is not disturbed. There is no damage to any of the ligaments that hold the elbow joint stable. The bone is protected afterwards. And the tendon is released without the attached muscle losing shape or form. Almost everyone who has this surgery can return to his or her previous level of work or activity.

References: Ghazi Rayan, MD, et al. V-Y Slide of the Common Extensor Origin for Lateral Elbow Tendonopathy. In The Journal of Hand Surgery. November 2001. Vol. 26A. No. 6. Pp. 1138-1145.