Minimally invasive surgery
The minimally invasive surgery differs in some important points from the two above mentioned. The procedure can be completed within 5 minutes and is always performed on an outpatient basis, although there are not yet many medical practices in Germany that perform this method. Here the skin incision is less than 1 cm long.
This reduces the risk of infection and scars. On the other hand, the orthopedic surgeon has less overview and some ossified areas, which are located a little further away from the point of origin of the muscles, may be overlooked. The biggest advantage of this type of surgery is that the patient is immediately mobile again.
Only on the first day after the operation a pressure bandage must be worn. Because the arm is hardly immobilized, less scar tissue is formed and the loss of function is limited for most patients to the postoperative pain, which cannot be avoided after any kind of surgery and should subside within 3 to 5 days, depending on the physical condition. Complete freedom from pain can be expected after 3 weeks to 6 months, depending on the severity of the tennis elbow and the healing process. The chances of success with this surgical technique are almost 90%.
RecidivismRecidivism
RecurrencesRecurrences after tennis elbow surgery are rare and can then be approached again conservatively and/or surgically.
Anaesthesia
In these two conventional procedures (Hohmann OP according to Wilhelm), the operation is performed under anesthesia.Depending on the case, this can be general, regional or plexus anaesthesia (anaesthesia in the armpit). The minimally invasive form can be performed under local anesthesia.
Operational Risks
Risks of this operation are mainly based on the relatively large incision and the associated high probability of post-operative infection of the wound or pronounced scarring, which impairs movement and cosmetics in the long term. Complete healing is achieved with open procedures (Hohmann-OPWilhelm-OP) in about 80% of cases. Correct and consistent follow-up treatment is of great importance for the success of the operation.
After the operation, the elbow is immobilized in an upper arm cast for about 8 to 14 days, depending on the severity of the injury. The patient will receive detailed information on this from his treating physician. He also determines after how many days the plaster splint can be removed and the stitches removed.
In addition, anti-inflammatory and pain-relieving medication is prescribed. To avoid possible complications, it is recommended to move the fingers under the plaster. This prevents thrombosis and swelling and at the same time promotes blood circulation.
After 2 weeks the load can be slowly increased. Postoperative physiotherapy allows the patient to strengthen his strength and stretching ability by means of adapted exercises and to restore the full function of the arm. The exercises should be performed regularly and also correctly at home.
It is important to ensure that they are not performed against pain, but rather according to the patient’s own ability to bear weight. Aftercare should be carried out regularly, with patience and rest, so that it has a lasting effect and prevents a recurrence of the problem. The chances of complete recovery are 80-90%.
When operating on tennis elbow, the affected tendon and muscle attachments are usually separated from the bone protrusion. After immobilization for 1-2 weeks, the arm should be moved through again. Careful stretching exercises are also part of the physiotherapeutic post-operative treatment after an operation of a tennis elbow.
These can prevent the tendon from re-growing at the elbow and thus a recurrence of the tennis elbow. The intensity of the exercises can be determined together with the treating physiotherapists and can also be done independently at home. Pain often occurs during stretching exercises and exercises with the Theraband.
At the beginning of the therapy, even a slight pain should initiate the end of the respective stretching exercise. Over time, the stretching can be performed up to the pain threshold. When the stretching exercises can be performed again without pain, the repetition of the exercises during the day can be increased. However, this should be done in consultation with the treating physician or the supervising physiotherapist.
