This is a retrospective review of 16 patients with recalcitrant tennis elbow treated with arthroscopic release of the extensor carpi radialis brevis and decortication of the lateral epicondyle. All patients underwent a period of conservative management with an average of 32 months with non-operative treatment. The average number of corticosteroid injections was 2.4 per extremity. Patients were followed for a minimum of one year and an average of 24 months.
Operative findings indicated that all 16 patients were reported to have a grossly degenerative lesion of the extensor carpi radialis brevis which was apparent through a thin layer of adherent capsule which was usually present. Associated pathology was found in 3 of the 16 patients. Outcome measurements included a subjective evaluation and a pain scale as well as length of disability and return to restricted work.
Only 12 of 16 patients were evaluated in follow-up. The overall subjective satisfaction rating of these patients was favorable, with 10 of 12 reporting feeling much better as a result of their surgery. Two reported feeling better, and none reported feeling the same or worse. No data was provided with regards to tennis strength or range of motion.
This is another paper that documents the feasibility of the treatment of lateral epicondylitis using arthroscopic techniques. Baker et al. have documented the success with the procedure previously and this small and uncontrolled study reinforces prior findings. A major weakness is the lack of a cohort group for comparison. An interesting aspect of this study is that the degenerative portion of the extensor carpi radialis brevis was reportedly evident in 16 of 16 cases. This has not been uniformly reported previously and the extent and location of the tendon degeneration in this condition remains poorly defined.
Link: www.arthroscopyjournal.org