Lateral epicondylitis, or tennis elbow, is a common condition that is by far the most common cause of elbow pain. This is due to a degeneration of the extensor tendon origin at the elbow of unknown cause. Golfer’s elbow (medial epicondylitis) is essentially the same pathology but on the inner aspect of the painful elbow.
These very common conditions lead to pain with even simple manual activities and are initially treated with activity modification, oral anti-inflammatories, therapy, and even injection of cortisone-like materials. However, in many patients who suffer with persistent and prolonged symptoms, despite conservative treatment, there are several minimally invasive procedures that may alleviate or diminish pain. The traditional open surgery involves a very large scar and aggressive scraping of the degenerative and inflamed tissue leading to a prolonged recovery and large scar. Arthroscopic elbow capsulectomy is a procedure where the lateral capsule of the elbow is removed and the inflamed tendon fibers are also removed using an arthroscopic procedure only requiring two small holes in the elbow. The physical therapist can begin range of motion exercises within 2 to 3 days of the surgery. This can be a technically challenging surgery and a bit less predictable. However, the simplest and currently most effective procedure for persisting tennis or golfer elbow, is ultrasonic ablation of the tendon origin using the Tenex® device.
This utilizes an ultrasonic probe, much like phacoemulsion for cataract surgery, to penetrate the tendon and ablate (remove) the degenerative tendon substance, also stimulating new blood supply and tendon origin formation. To augment this process, we often inject either PRP (platelet rich plasma taken from centrifuged patient blood) or an off the shelf more potent biologic, such as CTM® (Connective Tissue Matrix Biomedical).
This painless outpatient procedure allow for a much less painful and rapid recovery of the often-frustrating tennis elbow allowing return to normal activity and sports within a 2-4 week window with minimal post-procedure therapy.
Tennis (or golf) anyone? Further information can be found at www.DrBadia.com and initial assessment can be done with NO appointment via any OrthoNOW® center. Download the app when you want to notify us that you are “On My Way NOW™.”
Alejandro Badia, MD
Badia Hand to Shoulder Center
OrthoNOW immediate orthopedic care centers