Open Lateral Epicondylar Release

Arthroplasty is the replacement or reconstruction of a joint that has been damaged or has degenerated over time, as with arthritis. Glenohumeral osteoarthritis is the wearing out of cartilage in the shoulder joint. People who have severe osteoarthritis of the shoulder joint with accompanying long-term damage of the rotator cuff are candidates for Open Lateral Epicondylar Release. Patients with osteoarthritis of the shoulder and an intact rotator cuff are ideal candidates for a Open Lateral Epicondylar Release.

A lateral epicondylar release is an open procedure often performed through 3–4 cm incision on the outside of the elbow. During the procedure, the common extensor tendon is located and evaluated for any injury or damage. The tendon is split in order to remove damaged and inflamed tissue. The lateral epicondyle (bone) is also debrided in order to remove any scar tissue or inflammatory tissue that has developed as a result of long-term tennis elbow. Once this debridement is complete, the common extensor tendon is secured back to the lateral epicondyle (on the outside of the elbow) with strong suture. This provides a clean, non-inflamed edge now connected to bone, providing the tendon with more stability and less chance for recurrence when the patient resumes normal activities. Following the procedure, the patient is placed in a soft cast to immobilize the wrist and prevent any force applied by the wrist on the repair.

Post Operative Instructions:

SLING/MOVEMENT

  • If you underwent surgery to reattach your biceps tendon at the elbow, then you will be placed in a soft cast for one week after your surgery. This will limit the movement of your elbow so as not to disrupt your biceps tendon repair. You will also be given a sling that you may wear for comfort.
  • You may move your shoulder in any direction that is comfortable. Do not force the motion, because this will likely cause pain.

MEDICATIONS

  • An injection of local anesthesia was injected into your shoulder after the completion of the operation. This medication will wear off in five to six hours. Begin taking the pain medication (for example, Vicodin, Percocet, etc.) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every four hours until you go to bed.
  • The day after surgery you can take 600 mg of ibuprofen (Advil/Motrin) every six hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking ibuprofen, continue taking the pain medication every four to six hours as needed.
  • A sleeping medication (for example, Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your dressing is NOT waterproof. Do not get your soft cast wet. When you bathe, cover your arm with a plastic bag or trash bag to avoid getting your incisions wet.
  • Your soft cast will be removed at your first post-op visit. At that point you can start getting your incisions wet.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to one and a half hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Your cast will be removed, and your stitches will be taken out. Start icing the surgical area two to three times a day (or more if needed). Discontinue the sling as soon as possible to avoid stiffness. Physical therapy will be prescribed. Start physical therapy immediately to work on range of motion. Do not do any active biceps exercises or hold anything in that hand (not even a cell phone) for the first month after surgery.

Four weeks post-op: Second follow-up visit. Range of motion and strength test. Physical therapy will continue to improve range of motion. Mild stiffness is still common. You can start active biceps exercises, but still no resistance. You can start holding up to 2 lbs. in your hand (cell phone, coffee mug, etc.).

Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training is needed, continue physical therapy to work on these. Pain should be mostly resolved at this point.

Twelve weeks post-op: Fourth follow-up visit. Range of motion should be full/normal. You should feel stronger and have very little pain, if any. Near to full recovery is expected at this time.





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