Surgery for refractory lateral epicondylitis of elbow?

Lateral epicondylitis, also known as tennis elbow, is a condition characterized by pain and inflammation of the tendons attaching to the bony prominence on the outside of the elbow. Treatment is usually conservative, with options such as rest, ice, physiotherapy, and pain medication. Surgery is generally considered for cases that are refractory to these treatments and have failed to improve after 6-12 months.

Surgical options for refractory lateral epicondylitis may include:

1. Open surgery: This traditional surgical approach involves making an incision over the elbow to access and release the involved tendons. The affected tendons may be repaired or debrided (removal of damaged tissue). This technique allows direct visualization and treatment of the affected area.

2. Percutaneous release: This minimally invasive procedure is performed without an open incision. Instead, a needle or other instrument is inserted into the affected area to release the tight or inflamed tendons. This technique often requires specialized equipment and may be performed under ultrasound guidance.

3. Endoscopic surgery: This procedure utilizes a small camera (arthroscope) inserted into the elbow joint through small incisions. Instruments can then be inserted to release or repair the damaged tendons while viewing the affected area on a monitor.

4. Tendon transfer: In some cases where the damaged tendons are severely weakened, a tendon transfer procedure may be performed. This involves rerouting a nearby healthy tendon to the site of the affected tendon to provide reinforcement and restore function.

5. Lateral epicondylectomy: This procedure involves removing a portion of the bony prominence on the outside of the elbow where the affected tendons attach. It may be considered when the pain is primarily caused by impingement of the tendons against the bone.

The specific surgical approach recommended will depend on the severity of the condition, the patient's overall health, and the surgeon's expertise. Post-surgery, physical therapy and rehabilitation are essential to regain range of motion, strength, and functionality in the elbow.