Tennis Elbow Release Info Consent

Q: What does a non-surgical management plan look like?

A structured programme runs three components. Eccentric loading exercises — slowly lowering the wrist against resistance — gradually rebuild the tendon. Activity modification reduces the loads that triggered the tendinopathy: shifting from a thin-handled to a thick-handled grip, swapping pulling for pushing where possible, and pacing the activity. A cortisone or platelet-rich plasma (PRP) injection is offered to settle the active phase if exercises and activity modification aren't enough on their own. Most patients get significant relief from the combination over three to six months.

Q: What's the difference between cortisone and PRP injections — is one better?

Cortisone provides faster pain relief — patients often feel much better within a week or two — but the relief tends to be short-term and repeated injections may weaken the tendon. PRP takes longer to work (six to twelve weeks) and is uncomfortable for the first few days, but appears to give more durable relief in published trials and may modify the underlying tendinopathy rather than just suppressing pain. PRP is not Medicare-rebated and carries an additional out-of-pocket cost. The choice between them is individual.

Q: How successful is tennis elbow surgery?

Reported success rates after surgical release of the common extensor origin are around 80–90% — most patients report meaningful improvement in pain and grip function over six to nine months. Outcomes are best in patients with classic localised lateral epicondyle tenderness, MRI changes confined to the common extensor origin, and a thoroughly trialled non-operative programme. Patients whose pain has another underlying cause (see below) tend to do less well; that's why the diagnostic consultation matters.

Q: How much does tennis elbow surgery cost? What does Medicare cover?

Tennis elbow surgery is performed under regional or general anaesthesia, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

Q: What if my pain isn't actually tennis elbow?

Several other elbow conditions cause lateral pain and are confused with tennis elbow on initial presentation. Radial tunnel syndrome — compression of a branch of the radial nerve — produces aching pain a few centimetres below the elbow rather than at the bony point of the lateral epicondyle. Posterolateral rotatory instability of the elbow gives a sense of instability or clicking with certain movements. Capitellar pathology (cartilage damage on the joint surface) often gives mechanical symptoms — locking, catching, swelling. Confirming the diagnosis at the first consult is the single most important step in deciding what treatment will help; surgery for tennis elbow only works if tennis elbow is what's actually wrong.

Q: Will the pain come back after surgery?

True recurrence after a properly executed release is uncommon — the diseased portion of tendon is excised and the rebuilt extensor origin reattaches to healthy bone. Persistent or returning lateral elbow pain after surgery is investigated carefully; sometimes the original diagnosis was incomplete, or a different mechanism (radial tunnel, posterolateral instability) is contributing. Any concern post-operatively is worth raising at review.

Q: Do I need physiotherapy or hand therapy after surgery?

Yes — every patient sees the on-site hand therapist for the first dressing change, scar management, and a structured programme of gentle wrist motion and gradual eccentric loading. The therapy schedule typically runs over the first two to three months while the rebuilt extensor origin heals to bone. Hand therapy is integrated into the post-operative pathway, provided by Ruby Doolan through Extend Rehabilitation in the same suite as Dr Hirpara's rooms.

Diagram of tennis elbow showing the damaged tendon at the lateral epicondyle. — Tennis elbow: the extensor tendon has degenerated where it attaches to the lateral epicondyle (the bony bump on the outside of the elbow). The release operation removes the damaged tendon tissue. Wikimedia Commons 4.0

Tennis elbow release surgery — for persistent pain despite physiotherapy and other conservative treatments.

Why this operation has been suggested

Tennis elbow is a common condition where the tendons on the outside of your elbow become painful and inflamed. Most people recover within six months to one year without surgery, and about 90% of patients find their symptoms resolve on their own within a year. Because your surgeon cannot predict who will heal without help, they usually recommend trying non-surgical treatments first.

Your surgeon has suggested this operation because you have persistent symptoms that have not improved with standard care. This procedure involves making a single small cut to release the tight tendon causing your pain. It is designed for the small group of patients who do not respond to other methods. The main goal is to provide lasting pain relief and help you return to your normal activities.

Before the operation

Most people with tennis elbow get better without surgery, so your surgeon may suggest trying non-surgical treatments first. You might need an X-ray or MRI to check your elbow, or blood tests to ensure you are fit for the procedure. Please fast before your surgery and stop taking certain medicines as your surgeon instructs. Arrange for someone to drive you home and bring a list of all your current medications. Wear comfortable clothing to your appointment. Your surgeon will perform an open operation using a single incision over the painful area.

On the day

You will arrive at the hospital and meet your surgeon and the anaesthetist. They will review your health and answer any questions you have before you go to the operating theatre. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.

Your surgeon will make a single conventional incision over the operative site to perform the release. The procedure itself is brief, and you will wake up in the recovery area as the anaesthetic wears off. You will rest there for a short time while the nursing team checks that you are comfortable and stable before you go home.

What the operation involves

Your surgeon will make a single cut over the outer part of your elbow. This is an open approach, meaning they work directly through this one incision rather than using small keyhole cameras. They will carefully separate the tissues to reach the tendon that is causing your pain.

Inside, your surgeon will remove the damaged part of the tendon where it attaches to the bone. They may also gently scrape the bone surface to encourage healing. This process is called a release. It removes the worn-out tissue that is no longer working properly. Once the damaged area is cleared, your surgeon will close the cut with stitches or glue.

The procedure focuses only on the specific spot where the tendon is frayed. Your surgeon will not need to use special anchors or screws for this release. They will simply remove the bad tissue and let your body heal the rest. This direct approach allows them to see exactly what needs to be fixed.

After the operation

You will wake up in the recovery ward. Your surgeon uses a single conventional incision over your elbow. You will have a dressing and a sling or brace on your arm. Pain is managed with standard medication. You can usually go home the same day. You must have someone stay with you for the first 24 hours to help you. Most patients feel better quickly, though full recovery can take up to 12 to 18 months.

Recovery

Most people with tennis elbow find their symptoms fade on their own within one year. Your body has a steady healing rhythm, often resolving pain within three to four months. Because recovery happens naturally for most, surgery is usually reserved for those who do not improve with rest and therapy. If you do proceed, you can expect near 90% satisfaction with the results.

After your open surgery, you will have a single small incision over the sore spot on your elbow. In the first few days, you may feel some swelling and discomfort around this area. Your surgeon will guide you on using a sling or brace to protect the arm while you rest. You will likely need to sleep with your arm slightly elevated to help reduce swelling.

As the swelling settles, you will begin gentle movement exercises with your physiotherapist. You will focus on regaining strength and range of motion without straining the healing tendon. Your surgeon will tell you when it is safe to resume daily tasks like driving or lifting. Your specific timeline may differ from others, so follow the advice of your surgeon and physio team closely.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

Sometimes the pain in your outer elbow does not go away after surgery. This is more likely if you had many injections before the operation. If your symptoms do not improve, tell your surgeon at your next check-up.

Infection is a possible risk with open surgery. You might notice redness spreading from the cut, warmth, or swelling that gets worse. If you see these signs, call the clinic right away so they can treat it.

Rarely, the surgery might not work well enough, and you could need another operation later. This is uncommon, but if your pain returns or gets worse over time, let your surgeon know.

Your surgeon uses an open approach with a single cut over the elbow. While other methods exist, this specific technique carries a similar risk of complications to other ways of doing the surgery.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us if you have a fever, increasing redness, or discharge from your wound. Go to emergency if you feel sudden severe pain, swelling in your calf, or shortness of breath. Contact us immediately if you lose sensation or cannot move your arm. Most cases of tennis elbow resolve within 6 months without surgery. However, we need to see you if symptoms do not improve or get worse.