Lateral epicondylitis, commonly known as tennis elbow, is a painful condition affecting the tendons that join the forearm muscles to the outside of the elbow. This injury is primarily caused by repetitive strain and overuse, leading to degenerative changes and microtears in the extensor carpi radialis brevis tendon. Surgery is considered a last resort, reserved for severe, chronic cases where non-surgical treatments have failed to provide relief. Patients typically undergo conservative care, such as physical therapy, bracing, and injections, for a period of six to twelve months. The decision for surgery is made when persistent pain and functional limitation significantly impact a person’s ability to perform daily tasks after a year of unsuccessful treatment.
Pre-Surgical Preparation Timeline
The time commitment on the day of surgery requires the patient to arrive at the facility one to two hours ahead of the scheduled procedure. This initial window is dedicated to administrative and medical preparations to ensure patient safety and readiness. After check-in, a nurse conducts a preliminary interview, verifying the patient’s medical history and current medications, and the patient changes into a surgical gown.
The patient then meets with the surgical team, including the anesthesiologist, to discuss the planned anesthesia, which may be a local, regional nerve block, or general anesthetic. An intravenous line is typically placed, and the surgical site on the elbow is marked to confirm the correct location. The final preparation phase involves the administration of the chosen anesthesia before the patient is moved into the operating room for the actual procedure.
Duration of the Surgical Procedure
The time spent actively performing the tennis elbow surgery is generally brief for this type of outpatient procedure. The exact duration depends on the surgical technique used to remove the damaged tissue and reattach the healthy tendon to the bone.
Open Procedure
In an open procedure, a small incision is made over the elbow. The surgical time typically ranges from 45 to 60 minutes. This technique allows the surgeon direct visualization of the affected tendon.
Arthroscopic Procedure
The arthroscopic or minimally invasive technique uses small incisions, a camera, and specialized instruments. This method often has a shorter surgical duration, generally between 30 and 45 minutes. However, due to the technical demands of working through small portals, arthroscopic surgery can sometimes take slightly longer than the open method. Regardless of the technique, the patient is in the operating room suite for a longer total period than the surgical time, accounting for the final positioning and waking from anesthesia.
Immediate Post-Operative Timeline and Discharge
Immediately following the procedure, the patient is transported to the Post-Anesthesia Care Unit (PACU) for close monitoring. This period is dedicated to safely waking up from the anesthesia, managing initial pain, and ensuring stable vital signs. Patients usually spend approximately one to two hours in the PACU as the anesthetic effects wear off and they become fully alert.
Since tennis elbow surgery is typically an outpatient procedure, the total time from the end of surgery to being discharged home is relatively short. Once the medical team confirms that pain is controlled, the patient can tolerate fluids, and they are mobile enough, they are released. Patients can generally expect to go home within three to four hours after the surgical procedure concludes, though they must arrange for a ride home due to the effects of anesthesia.
Long-Term Recovery and Return to Activity
The long-term recovery phase begins immediately after discharge and progresses through several milestones. Initially, the elbow is immobilized in a splint or cast for protection, which is typically maintained for one to two weeks. During this initial period, the focus is on wound healing and controlling swelling and pain, often with the use of ice and prescribed medication.
Gentle range-of-motion exercises for the fingers, wrist, and elbow may begin as early as the first few post-operative days. Formal physical therapy often starts around two to four weeks after surgery. Adherence to a structured rehabilitation program is necessary for restoring flexibility and strength to the joint. Patients can usually return to light daily activities, such as self-care and desk work, within four to six weeks.
A return to more strenuous activities, including labor-intensive work or sports that stress the elbow, requires a much longer timeline. Strengthening exercises are gradually increased between six and twelve weeks, building up the necessary tendon resilience. Full recovery and return to high-demand activities or sports, such as tennis, generally takes four to six months, though it can take up to a year for maximum strength gains to be realized.