Although many tennis injuries can be treated without the need for surgery, surgery may be necessary if symptoms persist after a period of rest. Depending on the injury, there are different surgical options and recovery times.
Surgical Treatment Options
Generally, doctors will only recommend surgery if the injury is severe or does not improve with nonsurgical treatment. The goal of surgery is to relieve pain and restore function of the injured area. If you have one of the following injuries, these surgical procedures may be used to get you back in the game.
Surgery for tennis elbow is generally recommended if symptoms do not improve after 6 to 12 months of nonsurgical treatment. Surgery for tennis elbow usually involves removing damaged muscle and reattaching the tendon to the elbow. Depending on your individual needs, this procedure may be performed as an open surgery or arthroscopically. During an open surgery, your surgeon will make an incision over the elbow to access the injured area and make the repair. Arthroscopic surgery is less invasive than open surgery; a small camera is inserted into a smaller incision, allowing the surgeon to see the injured area without the need for a large incision. Small operating instruments are inserted into a second incision to perform the procedure. Arthroscopic surgery can often be performed as an outpatient procedure.
Rotator Cuff Tears
As with tennis elbow, surgery may be considered for a rotator cuff tear if 6 to 12 months of nonsurgical treatment does not yield any improvement. Surgery may also be considered if the tear is large or causes significant weakness or loss of function in the shoulder. The rotator cuff may be repaired with a traditional open procedure, arthroscopy, or a combination of the two. Open surgery is generally used in the case of large or complex rotator cuff tears. Arthroscopy is less invasive, as it allows the surgeon to reattach the torn rotator cuff through a smaller incision than is required during open surgery. A small camera inserted into the joint allows the surgeon to view the inside of the shoulder on a monitor during the procedure, rather than viewing it directly. A mini-open repair combines both techniques. An arthroscope may be used to assess the damage and remove any bone spurs, then the surgeon views the shoulder directly to repair the torn rotator cuff.
Stress Fractures in the Lower Back
Stress fractures in the lower back, a condition called spondylolysis, often heal without the need for surgery. However, if the spine is unstable or the condition interferes with everyday life, surgery may be recommended. In those cases, surgeons often recommend a spinal fusion. During this procedure, the surgeon uses a bone graft taken from the patient, an allograft (cadaver bone), or an artificial bone graft material to fuse the fractured bone together. The procedure does limit some of the movement in the spine, but should not limit the spine’s flexibility too much, as the procedure is done on only a small segment of the spine.
Patellar Tendonitis (aka Jumper’s Knee)
Unless the tendon is torn, it is not likely that you will need surgery. However, if the patellar tendon does tear, or if conservative treatment does not relieve pain and restore function, surgery may be considered. During surgery, the surgeon sutures the tendon to the kneecap, either by drilling holes in the kneecap or using suture anchors. If the surgeon feels the tendon is too short to reattach, a tissue graft may be used to lengthen the tendon.
Surgery is rarely required to heal a sprained ankle, and is only used if the ankle does not respond to nonsurgical treatment. If surgery is needed, the surgeon may use arthroscopy to view the structures of the ankle to see if there are any loose bone fragments or cartilage in the joint. If the ligament is torn, it may be sutured into place.
Recovery from Surgery
Following surgery, you will have to go through a period of recovery before you are able to get back on the tennis court. You may need to immobilize the area with a brace, sling, or splint for at least the first week or two after surgery. Rehabilitation also plays an important part in recovery. You will likely begin with light activities, gradually increasing the intensity of your activities over time. Recovery time varies with each individual patient and procedure. Many patients recover from surgery within 4 to 6 months, but some can take as long as a year to fully recover.
Most importantly, always follow your doctor’s instructions. Don’t try to play again until your doctor gives you the go-ahead. Following post-operative instructions will ensure that you are back on the court, fully recovered and with a lower chance of reinjury.