Tennis elbow release can be performed by either open or keyhole (arthroscopic) techniques. Both involve release of the degenerate ECRB tendon origin and are performed as a day-case procedures. Both techniques achieve comparable outcomes, with approximately 80% of patients better by six months. The arthroscopic technique has been shown to enjoy a swifter recovery; it also offers the ability to address any co-existing internal problems in the elbow.
The open technique requires a 2-3cm incision over the outer prominence of your elbow. The superficial muscles are elevated to expose the degenerate ECRB tendon beneath. The degenerate tissue of the ECRB tendon is excised.
In the keyhole technique, two 5mm portals allow a surgical telescope and instruments to be passed carefully into your elbow. Your elbow joint is inspected and the ECRB tendon, which lies just outside your joint capsule is then released from the inside. Any other problems discovered within your elbow (e.g. plica or cartilage defect) can normally be addressed at the same time.
Arthroscopic view of the elbow joint with a needle coming in through the lateral capsule. The ball on the right is the capitellum of the humerus. The concave bone on the left is the radial head. The lateral capsule is windowed to allow resection of the degenerate ECRB tendon which lies just beyond the capsule.
Golfers’ elbow release is performed via open technique. A 7 cm incision is centred over the medial epicondyle of your elbow and your ulna nerve is protected. The tendon origin is inspected for degenerate tissue, which is excised. The tendon origin is repaired to the bone. If you have had concurrent symptoms of an entrapped or irritable ulna nerve, then your ulna nerve will be released at the same time.
Of those who need surgery, 80% will be happy with their outcome by 6 months, but a few patients will continue to experience pain during certain activities. In general, golfers’ elbow tends to be a bit more resistant to treatment than tennis elbow.
Tennis elbow and golfers’ elbow surgery has a low complication rate.
Infection is rare. The risk of nerve injury is slightly higher with arthroscopic techniques, but it is still low and even if a nerve were injured, it would usually recover spontaneously (e.g. nerve bruised rather than cut). Stiffness can occasionally follow any surgery around the elbow, but it is rarely significantly troubling. A minority of patients will continue to suffer with pain around their elbow.
This is a day-case operation performed under general anaesthesia. Please begin your painkillers as soon as you get home and take them regularly for the first fe days. Please remove your bulky bandage after 3 days, but keep your sticky dressings dry and clean for two weeks. You will be seen at two weeks and any suture ends will be trimmed. You will need to do eccentric stretching and strengthening exercises as part of your rehabilitation. Your physiotherapist will guide you on these.
Patients vary in their recovery after this surgery, but for guidance, you may expect to return to:
Desk-based work approx. 3-6 weeks
Driving approx. 3-6 weeks
Return to heavy duties approx. 8-16 weeks
Making the right choice about the best treatment for you means getting the right information. During your consultation, please do feel free to ask Mr Granville-Chapman to explain anything that you do not fully understand, and for his advice about the pros and cons of any treatment.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
A very pleasant Consultant who knows exactly how to make pain go away.
Mr Granville - Chapman has an excellent bedside manner. He engaged with my 12 year old son at an appropriate level and took the time to ensure that he understood the procedure and answer all his questions. He is thoroughly professional and I would not hesitate to recommend him.
I have been very pleased with the attention I have received. Mr. Granville-Chapman has reassured me that my symptoms are normal. It is very easy to make appointments that suit me.
Mr Granville chapman I found be caring informative and professional I would recommend him to all if you have a problem don't hesitate to contact him you won't be disappointed.
I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
So far my experience with Mr Jeremy Granville-Chapman has been personal and informative with regard to the operation I will be having. I feel confident that my operation will be a success and for this reason I am very happy to have Mr Jeremy Granville-Chapman as my consultant.
Very knowledgeable and helpful. Takes the time to make sure you're getting the treatment you need.
Mr Jeremy Granville -Chapman is not only a highly skilled consultant but is able to put you straight away at ease .My appointments were arranged very swiftly which was great, when you are experiencing severe pain. I am very happy with my treatment so far . many thanks to everyone who was involved in my treatment.
Polite, helpful, professional. Makes an effort to ensure full understanding of issues and procedures to be done. Highly satisfied
Very pleasant. Clear, careful explanations & options/possibilities. I feel well informed, and happy that my concerns are being well addressed, with a plan of review of the symptoms.
Excellent advise with everything explained clearly and a successful treatment which has benefited be greatly.
BMI The Princess Margaret Hospital
Osborne Rd, Windsor SL4 3SJ
Spire Thames Valley hospital
Wexham Street, Wexham, Buckinghamshire, SL3 6NH
Wexham Park Hospital, Slough, Berkshire, SL2 4HL
Unit 6, Queen's Square, Ascot Business Park, Lyndhurst Road, Ascot, SL5 9FE