Tennis elbow treated in under 20 minutes

New procedure by SGH, Mayo Clinic uses ultrasound and toothpick-size probe

By Linette Lai, The Straits Times, 27 Dec 2013

TWO years ago, Madam Elaine Chew's left elbow hurt so much that she could not sleep. Painkillers and physiotherapy did not help after she was diagnosed with tennis elbow.

"It was so painful that I cried," said the 48-year-old. "I told my doctor that even if it needed surgery, I would go. I just wanted to get rid of the pain."

Her doctor at the Singapore General Hospital (SGH) recommended a new procedure which did not even need stitches.

After ultrasound imaging is used to identify the damaged tendon tissue, a probe "about the size of a toothpick" is inserted to remove it. Performed under local anaesthesia, the whole process takes just 15 to 20 minutes.

Those who undergo conventional tennis elbow surgery have to be stitched up, may need to stay overnight for observation and could be on painkillers for as long as a month.

But with the new method, the patient only needs a simple adhesive bandage instead of stitches and can be discharged on the same day.

It was part of a collaboration between SGH and the Mayo Clinic in the United States, the results of which were published in a medical journal this year. SGH is the only centre in Asia that offers the new procedure, which it has used to treat about 40 patients, 20 of whom were participants in the study.

"It provides patients who are hesitant or fearful of surgery with another treatment option as it is performed in an outpatient clinic setting," said Dr Joyce Koh, a senior consultant with the SGH's department of orthopaedic surgery. "Recovery is also much shorter compared with traditional open surgery."

Madam Chew, who underwent the new procedure on both elbows, said: "The pain before the surgery was much worse than the pain during it," she said. "And now, there is no pain any more."

Tennis elbow occurs when the tendons in the elbow are overworked, usually due to repetitive motions of the wrist and arm. The condition is most commonly seen in those aged between 35 and 55.

Despite its name, most cases occur in people who do not play tennis. Instead, patients tend to be delivery personnel or those who do administrative work or plenty of housework, said Dr Koh.

"In these jobs, there can be a lot of repetitive movement, like carrying heavy files or lifting bamboo poles."

She added that the hospital sees about 20 to 30 patients with tennis elbow every month. Only 10 to 20 per cent, however, have conditions serious enough to require surgery.