Lateral epicondylitis: a comparative study of open and arthroscopic lateral release.

Lancaster Orthopedic Group, Lancaster, Pennsylvania, USA.
American journal of orthopedics (Belle Mead, N.J.) 12/2004; 33(11):565-7.
Source: PubMed

ABSTRACT In this article, we retrospectively review cases of resistant lateral epicondylitis (tennis elbow) and compare treatment with open release versus arthroscopic release. From 1997 to 2002, 87 patients were treated: 54 with open procedures and 33 with arthroscopic procedures. Seventy-five patients were available for follow-up. Mean duration of preoperative symptoms was 16 months for open cases and 22 months for arthroscopic cases. All patients had a minimum of 6 months of conservative treatment before surgery. Results showed no significant difference in outcomes. For example, 69% of open cases and 72% of arthroscopic cases had good or excellent outcomes. Notably, patients treated with arthroscopic release returned to work earlier than patients treated with open release did, and they required less postoperative therapy.

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    ABSTRACT: Most patients diagnosed with lateral epicondylitis respond well to conservative management. For patients who do not respond to nonoperative modalities, surgical treatment represents a viable option for long-term symptomatic relief. The arthroscopic surgical technique described in this article has been consistently used by the senior author for the treatment of recalcitrant lateral epicondylitis for more than 5 years (198 patients) without the occurrence of any major complications and appears to be a safe, reliable, and efficacious surgical intervention for the management of lateral epicondylitis.
    Arthroscopy techniques. 02/2014; 3(1):e135-9.
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    ABSTRACT: PURPOSE: The purpose of this study was to compare the outcome of arthroscopic and open tendon release in tennis elbow (TE). METHODS: We compared the outcome of patients treated by an open tendon release in the period from 2002 to 2005 (n = 80) with that of patients treated by an arthroscopic release of the extensor carpi radialis brevis in the period from 2005 to 2008 (n = 225). In both groups the inclusion criteria were symptomatic TE refractory to conservative care for a minimum of 6 months and a clinical follow-up of at least 3 years. The diagnosis was based on a typical history and positive clinical findings. Patients with previous surgery in the elbow, chondral or osteochondral lesions, osteoarthritis, or free bodies were excluded. To have a similar follow-up period in the 2 groups (median, 4 years), the follow-up was conducted at 2 different time points. RESULTS: The groups did not differ significantly with regard to the age of the patients, distribution of gender, distribution of affected side, duration of symptoms, or baseline score on the short version of Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). We did not observe any major complications. The failure rate was not significantly different between the 2 groups. At follow-up, the mean QuickDASH score was statistically significantly better (P = .004) in the arthroscopic group (11.6 points; SD, 15.6 points) compared with that in the open group (17.8 points; SD, 19.4 points). The percentage of elbows with an excellent outcome at follow-up (QuickDASH score <20 points) was significantly higher in the arthroscopic group (78%) than in the open group (67%) (P = .04). CONCLUSIONS: Both a traditional open approach and the newer arthroscopic method provide an effective treatment of recalcitrant TE without major complications. The arthroscopic method offers a small, but not insignificant, improvement in the outcome as evaluated by the QuickDASH score. LEVEL OF EVIDENCE: Level III, therapeutic case-control study.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2013; · 3.10 Impact Factor
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    ABSTRACT: Lateral epicondylitis of the elbow is a relatively common pathology and would involve 1-3% of the overall population. Lack of consensus on surgical techniques reflects the difficulty of understanding and treating this disease. Our prospective study reports the results of its arthroscopic treatment on 14 patients operated on between 2009 and 2012. The mean follow-up was 7.15 months. All patients underwent a well conducted medical treatment for an average of 32.5 months. The operation was carried out under regional anesthesia in an outpatient. The technique included a time of joint exploration, joint capsulotomy and a transverse division of the pathological tendon of extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC). The value on the visual analogic scale (VAS) at rest and during exercise increased from 2.85 to 0.43 and from 7.71 to 2.43, respectively, then remained stable over time. Professional activity was resumed on average at 9.1 weeks. Neither intraoperative nor postoperative complications were found. No laxity was observed. The Mayo Clinic and DASH scores were significantly improved from 52.14 to 92.5 and from 54.11 to 9.7, respectively. Overall, we observed 11 very good and three good results. Although our prospective series has a few patients and limited follow-up, our results are better or similar than those reported in the literature on pain relief and functional recovery. In contrast, the average recovery of professional activity was longer. Elbow arthroscopy, less invasive than open procedures, and allowing further joint exploration, seems an excellent alternative technique in this indication.
    Chirurgie de la Main 03/2013; · 0.30 Impact Factor