Golfer's elbow surgery is an operation to release the common flexor tendon origin from the medial epicondyle (inner elbow bone) for chronic medial epicondylitis that has not responded to non-operative treatment.
A small incision is made over the medial epicondyle. The degenerate portion of the common flexor tendon origin is identified and excised. Healthy tendon edges are reattached. The ulnar nerve, which runs directly behind the medial epicondyle, is identified and protected — and may be transposed (moved) if it is contributing to symptoms. The operation takes 30–60 minutes.
Surgery is considered when medial epicondylitis has not responded to at least six to twelve months of non-operative treatment including physiotherapy (eccentric exercises), corticosteroid injection, shockwave therapy, and activity modification.
Physiotherapy (eccentric wrist flexor exercises), counterforce bracing, corticosteroid injection, PRP injection, shockwave therapy, and activity modification. Most patients (80–90%) improve without surgery.
Clinical diagnosis. Ultrasound or MRI may show tendon thickening and degeneration. Nerve conduction studies if ulnar nerve symptoms are present. Day-case procedure.
Pain relief and restoration of grip strength in approximately 80–85% of patients. Recovery is gradual.
Full strength recovery takes three to six months.
Some patients have persistent mild medial elbow ache.
Over the medial epicondyle.
The ulnar nerve is intimately related to the surgical field. Numbness or tingling in the ring and little fingers.
If the MCL is inadvertently damaged during surgery.
Wound infection.
Surgery may not fully resolve symptoms.
Temporary.
General or regional arm block anaesthesia.
Splint for one to two weeks. Gentle wrist and elbow exercises from two weeks. Progressive strengthening from six weeks. Return to desk work at two to four weeks. Manual work at three to four months. Full recovery four to six months.
Review at two weeks and six weeks.
No. Golfer's elbow (medial epicondylitis) affects the inside of the elbow — the common flexor tendon origin. Tennis elbow (lateral epicondylitis) affects the outside — the common extensor tendon origin. Treatment principles are similar but the anatomy and surgical approach differ.
Approximately 10–20% of patients with medial epicondylitis do not respond adequately to conservative management, particularly those with manual occupations or significant tendon degeneration.