Surgical therapy | Treatment of a tennis elbow

Surgical therapy

Surgery is indicated when conservative therapies cannot eliminate the symptoms and tendon ruptures or a chronic course is present. At least 6 months of unsuccessful treatment with all conservative therapies should be considered before surgical therapies are considered. There are various surgical procedures that can be used.

As a rule, however, a tendon tendotomy can be performed to relieve symptoms. The different surgical procedures are described below:

• Operation according to Hohmann: Hohmann’s operation begins on the radial side of the elbow, i.e. on the outside. Here an arch-shaped incision of about 5 cm in size is made.The muscle origins of the stretching muscles are then displayed and detached.

  The incision of the tendons runs in a transverse direction, therefore the procedure is also called transverse incision. The elbow ligaments are also inspected. Changes (e.g. cartilaginous-bony adhesions), which can also cause pain, can be removed.

• Operation according to Wilhelm (denervation): The operation according to Wilhelm is the second standard procedure for the treatment of tennis elbow.

  This procedure is usually used in combination with the Hohmann operation. In this procedure, small nerve branches are sclerosed, which innervate (supply) the outer area of the elbow. This operation is also used to treat golfer’s elbow.

• Operation according to Goldie: The operation according to Goldie is similar to the procedure according to Hohmann.

  However, the incision of the muscle tendons is not transverse but longitudinal. This is therefore a longitudinal incision. This procedure is also often combined with the operation according to Wilhelm.

• Minimally invasive therapy: A minimally invasive treatment is carried out by means of an incision no longer than 1.5 cm long on the outside of the elbow. Here too, the muscle tendons are notched in a similar way to the Hohmann operation. In very pronounced cases, however, a conventional surgical procedure is more appropriate, as the bones, muscles and the ligamentous apparatus can be better assessed and displayed in this way.