This study examines the intra-articular anatomy of the lateral elbow as it relates to tennis elbow. The extensor complex was arthroscopically debrided in 7 elbows to determine the extent of resection possible. Elbow stability was then assessed. Results showed that arthroscopic resection can allow for complete release of the extensor carpi radialis brevis (ECRB) and the extensor digitorum communis (EDC). Instability did result if resection proceeded posterior to the midline of the radial head. Progressive posterolateral instability was noted with posterior release of the lateral ligament origin.
This cadaveric study lends additional support for the ability to release the extensor tendon origin arthroscopically from within the elbow joint. As long as the anatomical landmarks are understood, tendon release should be able to be performed in a reproducible manner. It is unclear, however, if the costs, time and potential morbidity of this approach make it the most appropriate for the rare patient with lateral epicondylitis who fails conservative treatment measures. Furthermore, the addition of a new technique with small skin incisions should not lead to a change in the indications for surgery for this commonly self-limiting condition.
Journal Shoulder Elbow Surg