Orthobiologics vs. Surgery for Tennis Elbow
So how do orthobiologics compare to traditional treatments for common conditions or injuries? To answer that question it’s often helpful to look at some examples, in this instance a typical scenario involving a 45-year-old male patient named John who was suffering from tennis elbow (lateral epicondylitis).
When John came to see me he was frustrated. Despite multiple conventional treatments — which included bracing, massage, physical therapy, and corticosteroid injections — he had seen little relief from his symptoms. In cases like John’s, there are two options. One is traditional surgery, which follows these general steps:
1. The patient receives a local anesthetic to numb the area.
2. A small incision is made over the lateral elbow.
3. The damaged tendon attachment is surgically treated — either by removing the degenerative tissue, by thermal treatment, or, in some cases, removal of a small amount of bone.
4. The incision is then closed, and the elbow is immobilized in a splint for 10–14 days.
5. Following removal of the splint, the patient undergoes physical therapy to restore strength and mobility.
Full recovery from this procedure generally takes about twelve weeks. While this approach has been proven effective, the downsides are obvious. The procedure itself is invasive (presenting risks like infection, scarring and stiffness), and the process is time-intensive, requiring structured rehabilitation that can take up to twelve weeks.
Now let’s compare that to the orthobiologic approach. In this case, instead of conventional invasive surgery, the treatment consists of a minimally invasive process that uses the body’s own mechanisms to spur healing and tissue regeneration. A typical treatment for tennis elbow proceeds like this:
1. A small amount of fat is harvested from John’s flank through a tiny incision, collecting the fat in a syringe.
2. 60cc’s of blood is drawn and processed in a centrifuge to concentrate platelet-rich plasma (PRP).
3. Using ultrasound guidance, the damaged elbow tendon is precisely identified.
4. A combination of the patient’s own fat and platelet rich plasma (PRP) is injected directly into the affected area to stimulate healing.
5. The patient returns home the same day with minimal restrictions.
Recovery from this procedure is very different relative to the conventional approach. While there is typically some short-lived soreness (lasting up to 72 hours), there are no stitches or bandages, and no splint is required.
Instead of waiting up to twelve weeks, most patients begin noticing improvements at around four weeks and can return to full activity within about six weeks as symptoms allow. The approach boasts a success rate of 90% or greater success rate, and better still it promotes true tendon regeneration and healing versus tissue removal through surgery.
In this instance, the choice is clears. Compared to the traditional surgical approach, orthobiologic treatment offers several key benefits:
It’s minimally invasive. No large incisions or prolonged downtime.
It provides faster recovery. The patient returns to activity sooner, with little to no physical therapy.
It fosters natural healing. The damaged tendon is repaired, not removed or thermally treated.
It reduces risk. Surgical complications such as infection, scarring, and stiffness are avoided.
No surprise then that John ultimately chose orthobiologic treatment, which provided not only a highly effective alternative to surgery, but an excellent outcome with fewer risks and a quicker return to daily activities.
For more on orthobiologic treatments and their effects on specific conditions, look at my other posts!