Surgical management is indicated in the 5% to 10% of
cases in which nonoperative treatment fails to provide
lasting relief in a reasonable length of time. Assessment
of the individual patient’s functional requirements provides
the critical factor in timing. Some may be willing
and able to endure a year or more of pain and disability,
whereas others, particularly professional athletes and
manual workers, are given the option of earlier surgical
repair to shorten the period of disability.
There is no merit in a prolonged delay in offering
surgical treatment in the face of persisting symptoms.
This author’s own experience is similar to that of Newey
and Patterson, who found that pain relief was significantly
better in those patients with the shorter duration of