Tennis Elbow Procedure Demonstrates Long-term Success

"This is the first longitudinal study of arthroscopic treatment of tennis elbow," says lead investigator Champ L. Baker, III, M.D., an orthopaedic resident at the University of Pittsburgh. "The initial success from our original short-term study was maintained long term. I am happy to say that arthroscopic release is a good treatment option for lingering tennis elbow." The patients were enrolled through the Hughston Clinic in Columbus, Ga., where Dr. Baker's father and the senior study investigator, Champ L. Baker, Jr., M.D., practices orthopaedic sports medicine surgery.

Tennis elbow, a potentially debilitating condition, is common and can be successfully managed without surgery in almost 90% of cases. When it cannot be controlled by nonoperative measures, including rest, the arthroscopic technique used in this study is one of the many different surgical options that have good outcomes.

Investigators studied the long-term (130 month) pain and functional scores of 30 patients who underwent arthroscopic release for tennis elbow. The short-term results from this patient group were published in The Journal of Shoulder and Elbow Surgery in 2000 (9:475-82).

The researchers found that arthroscopic treatment provided very good results in terms of long-term pain relief and functional restoration. There were no repeat surgeries or injections. Satisfaction rates were also high, with 93% of the patients stating that they would have the surgery again if needed.

Athletes are not the only population vulnerable to tennis elbow. People in their 40s and 50s who do repetitive activities are often afflicted. Such activities can range from repetitively lifting boxes to repetitive wrist extension during long-term keyboard use. Tennis elbow pain is generally felt on the outside of the elbow.

"In 1880, lateral epicondylitis was termed 'tennis elbow,' but it could just as easily be called 'politicians' elbow,' because they run for office with their right hands -- 500 handshakes a day," explains the elder Dr. Baker, immediate past president of the AOSSM. This condition is caused by repetitive motion with the arm extended and the wrist moving up and down.

"If you've had tennis elbow for more than a year and can't get better, then it would be a good idea to investigate having this procedure done by an orthopaedic surgeon skilled in arthroscopy. Patients should get better with very few complications, if any," continues Dr. Baker.

Dr. Baker adds that there are other advantages to arthroscopic surgery: "I can look inside the joint to spot additional problems. Arthroscopic surgery speeds up the rehabilitation. In all published studies, return to work and play is much quicker with arthroscopic technique versus open surgery, while the complication rate is equal or less."