24359 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment

Name of the Procedure:

Tenotomy, Elbow, Lateral or Medial (e.g., Epicondylitis, Tennis Elbow, Golfer's Elbow); Debridement, Soft Tissue, and/or Bone, Open with Tendon Repair or Reattachment

Summary

In this procedure, a surgeon makes an incision near the elbow to access and repair damaged tendons caused by conditions like tennis elbow or golfer's elbow. The surgeon will also clean out (debride) any diseased tissue or bone to promote healing.

Purpose

This procedure is designed to relieve pain and restore function in the elbow by removing damaged tissue and repairing or reattaching tendons. It aims to address issues like epicondylitis, which is inflammation and microtearing of elbow tendons.

Indications

• Persistent elbow pain unrelieved by other treatments
• Difficulty in performing daily activities due to elbow pain
• Diagnosed conditions like tennis elbow, golfer's elbow, or epicondylitis
• Failed non-surgical treatments such as physical therapy or medication

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments, particularly blood thinners, may be necessary.
• Pre-procedure assessments, such as X-rays or MRI scans, to evaluate the extent of tendon damage.

Procedure Description

1. Anesthesia: Administered to ensure the patient is comfortable and pain-free, usually a local anesthesia or regional block.
2. Incision: A small incision is made on the lateral or medial side of the elbow.
3. Debridement: The surgeon removes any diseased or damaged tissue and bone using specialized tools.
4. Tendon Repair/Reattachment: The damaged tendons are then repaired or reattached to the bone.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 60 to 90 minutes.

Setting

Usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or anesthesia specialist
• Surgical technician

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel injury
• Stiffness or loss of range of motion
• Failure to relieve symptoms, requiring further surgery

Benefits

• Relief from chronic elbow pain
• Improved elbow function and strength
• Ability to return to daily activities and sports

Recovery

• Post-procedure pain managed with medications and ice packs.
• Arm may be in a sling or splint to immobilize the elbow.
• Physical therapy usually starts a few weeks after surgery.
• Recovery time varies but typically ranges from 6-12 weeks.
• Follow-up appointments to monitor healing progress.

Alternatives

• Non-surgical treatments, such as physical therapy, steroids, PRP injections, or NSAIDs
• Arthroscopic surgery, less invasive but may not be as effective for extensive damage
• Pros and cons: Less invasive alternatives may have shorter recovery but could be less effective for severe cases.

Patient Experience

• During the procedure, no discomfort should be felt due to anesthesia.
• Post-operatively, expect some pain and swelling managed with medication.
• Gradual return to normal activities with physical therapy guidance.
• Follow care instructions carefully to ensure optimal recovery.