This is a review of 10 biopsy specimens from patients undergoing surgery for chronic recalcitrant lateral epicondylitis. The specimens were taken from the Extensor Carpi Radialis Brevis Tendon. Specimens were stained for H and E, multiple assays, and Immunostaining. The authors graded the extra cellular matrix, apoptotic rate, cell death rate, cell density, and type I collagen content.
The results demonstrate that apoptotic and autophagic cell death occur in the extensor Carpi Radialis Brevis Tendon. These rates were increased as the extra cellular matrix became more involved with advanced breakdown of collagen structure.
This data supports the current understanding that there is a decrease in cellularity, degeneration of collagen quality and an increased rate of apoptosis in patients with chronic lateral epicondylitis.