Surgery to treat tennis elbow is rarely performed, and is usually considered the treatment of last resort if other nonoperative treatment modalities fail to produce adequate pain relief after 6 to 12 months.3 Moreover, there is no consensus in the medical literature as to which surgical technique(s) work best.

Surgery to treat tennis elbow is generally performed by orthopedic surgeons who have additional fellowship training in sports medicine. It is considered an elective surgery, which means that performing the surgery is not an essential lifesaving procedure, and it is ultimately the patient's decision whether or not to have the surgery. Persons whose pain is so debilitating that it impairs their ability to work and/or lead a normal life may be candidates for tennis elbow surgery if nonsurgical treatment options have failed.

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While techniques vary, the main objective of tennis elbow surgery is to remove damaged muscle and tendon tissue from the lateral epicondyle bone, then reattach it to healthy surrounding tissue. The success rate for full symptom relief following tennis elbow surgery is 80 to 90%.3 Most of the time, the surgery is performed on an outpatient basis, which means that the patient goes home the same day as the surgery.

Surgical treatment options for tennis elbow include:

    Open surgery of the elbow. In this type of surgery, an incision about 3 to 4 centimeters long is made over the elbow and surgery is performed on the affected tendon(s) and/or muscles. This procedure generally involves removal of the damaged portion of the tendon and suturing the remaining normal tendon back together.

    Arthroscopic surgery of the elbow. Repair surgery of the affected tendon(s) and/or muscle(s) may also be conducted via arthroscopy, in which small instruments are inserted through smaller incisions made under video guidance. The goal of arthroscopy is similar to open surgery in that damaged tissues are removed.

Following surgery, patients will usually undergo an extended period of rehabilitation of up to six months, including postsurgical recovery and physical therapy, before returning to the prior activity levels.

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