Tendinosis of the Extensor Carpi Radialis Brevis: Evaluation of Three Methods of Operative Treatment

Author(s): Szabo SJ, Savoie FH, Field LD, Ramsey JR, Hosemann CD

Source: Journal of Shoulder and Elbow Surgery 15:6 721-7, 2006.

Summary:

This is a retrospective review of patients treated surgically for recalcitrant lateral epicondylitis by a single surgeon using a standard Nirschl procedure, arthroscopic release, or percutaneous release of the extensor tendon.  One hundred and nine patients were enrolled.  All patients underwent conservative management with a mean of 1.35 corticosteroid injections pre-operatively.  Data was accumulated in a prospective fashion with a minimum two-year follow-up.  The authors enrolled 24 patients in the percutaneous release group, 44 patients in the arthroscopic release group, and 41 patients in the open release group.  Follow-up was at a mean of 48 months.  The authors used the Andrews-Carson score for their pre- and post-operative data collection.  The Andrews-Carson score was a mean of 160 pre-operatively and a mean of 195 post-operatively.

In their evaluation, the authors noted that open, arthroscopic and percutaneous treatments were all effective in the management of this disorder and all procedures had similar outcomes at two years.  There was no statistical difference in recurrence rates or failures.   In addition, they concluded that there were no differences in outcome scores when intra-articular and concomitant pathology was addressed, in comparison to a population in which tendinosis alone was addressed.  The ability to treat the intra-articular pathology arthroscopically did not result in superior outcomes.

While the authors’ conclusions may not be validated on the basis of a power study, the results do indicate that there is continued difficulty in determining which patients will have a successful outcome following treatment of lateral epicondylitis.

 
Tennis, Elbow, Lateral, Epicondylitis, Arthroscopic


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