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Tennis elbow This is the name given to what is thought to be a chronic tear of the attachment of five muscles combined into a common tendon called the common extensor origin which attaches to bone on the outer aspect of the elbow called the lateral epicondyle. It is commonly found in 40 - 60 year olds and females are affected more than men. In Mr Field's opinion this operation should not be performed before the patient has tried conservative measures for a period of 18 months as in a lot of cases symptoms will improve of there own accord. ANAESTHETIC General or regional anaesthetic. OPERATIVE PROCEDURE This procedure is generally performed under general anaesthetic. An incision is made over the outer aspect of the elbow directly over the bony prominence. The common extensor origin (the combined tendon with the five muscles) is identified attaching to this bone and a circular incision is made in the tendon that is attached to this bone and the tendon is stripped away from the bone by sharp dissection (directly with a knife). Mr Field likes to identify the joint through this incision and then saw the attachment to the tendon is removed from the bone the tendon is left in situ and the wound is sewn up generally with some buried absorbable sutures and nylon sutures to the skin. Result: I think this operation is about 50% successful. In this case it means 50% of people will show some improvement in their symptoms. It is rare that the symptoms are made worse by this operation. POST OPERATIVELY A mepore dressing is placed over the wound and a bulky bandage over the elbow which should be maintained for one week. The bandage can be removed at one week but the mepore dressing should be left on for a further week. Review in outpatients at two weeks for removal of sutures. A patient can normally return to work between 2 - 4 weeks after the operation. COMPLICATIONS
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