Lateral Epicondylitis: Anatomic Relationships of the Extensor Tendon Origins and Implications for Arthroscopic Treatment

Author(s): Cohen MS, Romeo AA, Hennigan SP and Gordon M

Source: J Shoulder Elbow Surg 17: 954-60, 2008.

Summary:

This is a cadaver study that defines the anatomic landmarks of the extensor carpi radialis brevis, extensor carpi radialis longus, and extensor digitorum communis from an arthroscopic perspective.  The authors first performed cadaveric dissections to define the bony and soft-tissue landmarks at the elbow.  In addition, they defined the relationship of the posterior interosseus nerve to the radiocapitellar joint and to the lateral epicondyle.  They then performed arthroscopy on additional specimens in order to determine if the ECRB tendon origin could be identified arthroscopically and released effectively and safely.

The results show that the ECRB has a reproducible origin at the humeral epicondyle between the midline of the radiocapitellar joint posteriorly to the top of the capitellum anteriorly.  The bony footprint measures on average 13 X 7 mm.  Once the joint capsule is released, the tendon origin can be defined and safely released using arthroscopic methods.  It remains to be determined if arthroscopic treatment of this condition is superior to standard open approaches.  However, this paper provides a nice review of the anatomy for anyone treating tennis elbow surgically, regardless of the approach.