Name of the Procedure:

Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open

Summary

This surgical procedure involves making an incision (open method) to cut tendons and remove damaged tissue or bone from the elbow to relieve pain and improve function. It is commonly performed to treat chronic conditions such as tennis elbow or golfer's elbow.

Purpose

The goal of the procedure is to alleviate pain and restore range of motion in the elbow caused by tendinosis or tendinitis, conditions where the tendons of the elbow become inflamed and degenerated due to repetitive stress.

Indications

• Persistent elbow pain not relieved by conservative treatments (e.g., rest, physical therapy, medications)
• Diagnoses of lateral epicondylitis (tennis elbow) or medial epicondylitis (golfer's elbow)
• Significant limitations in elbow movement and daily activities due to pain

Preparation

• Follow physician's instructions on fasting, typically no food or drink 8 hours before surgery
• Adjustments to medications may be necessary, particularly blood thinners
• Pre-surgical assessments including physical exam, imaging tests (e.g., X-ray, MRI), and blood work

Procedure Description

1. Patient is placed under regional or general anesthesia.
2. An incision is made on the lateral or medial side of the elbow.
3. Tendons are accessed and the surgeon performs a tenotomy, cutting the tendons.
4. Damaged soft tissue and/or bone is debrided (removed) to promote healing.
5. The incision is then sutured closed, and a sterile bandage is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This surgery is performed in a hospital or surgical center with appropriate facilities.

Personnel

• Orthopedic surgeon or specialized surgical professional
• Anesthesiologist or nurse anesthetist
• Surgical nurses and assistants

Risks and Complications

• Infection at the incision site
• Nerve or blood vessel damage
• Prolonged pain or stiffness in the elbow
• Limited success in pain relief
• Complications from anesthesia

Benefits

• Reduction or elimination of elbow pain
• Improved function and range of motion in the elbow
• Allows return to normal activities and sports

Recovery

• Post-surgical care includes pain management and preventing infection
• Use of a sling or brace temporarily to immobilize the elbow
• Physiotherapy typically begins a few weeks post-surgery
• Full recovery and return to normal activities may take 3 to 6 months
• Follow-up appointments to monitor healing progress

Alternatives

• Non-surgical treatments including physical therapy, medications, and corticosteroid injections
• Minimally invasive procedures such as arthroscopic debridement
• Platelet-rich plasma (PRP) injections
• Pros include less invasive options and lower immediate risks, but may not provide long-lasting relief compared to open tenotomy

Patient Experience

During the procedure, patients will be under anesthesia and should not feel pain. Postoperatively, they may experience swelling, discomfort, and soreness at the surgical site, which can be managed with prescribed pain medications. Physical therapy will be required to regain strength and mobility, and full recovery depends on adherence to post-operative care and rehabilitation plans.