Tennis elbow release is a surgical procedure to treat chronic lateral epicondylitis (tennis elbow) that has not responded to non-operative treatment. It involves removing or releasing the damaged tendon tissue at the outer elbow.
A small incision (3–5 cm) is made over the outer aspect of the elbow. The damaged, degenerate portion of the common extensor tendon origin is identified and excised. The remaining healthy tendon is repaired. Some surgeons also release the tendon from the bone. The procedure can also be performed arthroscopically. It usually takes 30–45 minutes and is performed as a day case.
Surgery is considered when tennis elbow causes persistent pain at the outer elbow that has not responded to at least six to twelve months of non-operative treatment, including rest, physiotherapy, bracing, and possibly injections.
The vast majority of tennis elbow cases resolve without surgery. Options include activity modification, eccentric strengthening exercises, forearm bracing, anti-inflammatory medication, corticosteroid injection, and shockwave therapy. Studies suggest approximately 80–90% of patients improve without surgery within 12 months.
Standard pre-assessment. This is a day-case procedure usually under general or regional anaesthesia. Arrange transport home and plan for limited use of the affected hand for several weeks.
The aim is to relieve pain and restore grip strength. Surgery is successful in approximately 80–85% of patients, though improvement may take several months to be fully realised. It is important to have realistic expectations — some patients continue to experience mild symptoms.
Around 15–20% of patients may not achieve complete pain relief.
Grip strength may be reduced initially and takes weeks to months to recover.
Scar tenderness at the incision site, usually settling over weeks.
Uncommon wound infection, usually managed with antibiotics.
Small sensory nerves near the incision may be damaged, causing numbness.
Very rare if excessive tissue is released. Careful surgical technique prevents this.
Can be performed under general anaesthesia, regional arm block, or local anaesthesia depending on surgeon and patient preference.
The arm is rested in a sling for comfort for a few days. Gentle movements begin immediately. Strengthening exercises start at around four to six weeks. Return to desk work is usually within one to two weeks. Manual work and sport may take three to six months. Full recovery can take up to six months.
Wound check at two weeks. Surgeon review at six weeks. Physiotherapy as needed to restore strength and function.
Tennis elbow resolves without surgery in the majority of patients. Surgery is reserved for cases that have not improved after at least six months of dedicated non-operative treatment.
Recurrence after surgery is uncommon but possible. Maintaining forearm conditioning and avoiding repetitive strain helps prevent this.
Usually at three to six months, depending on recovery. A gradual return with physiotherapy guidance is recommended.