ElbowArthroscopic debridement of the extensor carpi radialis brevis for recalcitrant lateral epicondylitis
Section snippets
Materials and methods
Institutional Review Board clearance was obtained from Rush University Medical Center, Chicago, Illinois (study No. 04101806).
Patients enrolled in this study were operated on during a 3-year period from January 2001 to January 2004. The inclusion criteria included lateral epicondylitis for which conservative treatment measures failed, consisting of anti-inflammatory medication, physical therapy, and corticosteroid injections for a minimum of 6 months.
All patients underwent an examination and
Results
In total, 36 patients met the study criteria, 24 men and 12 women. The mean age at the time of surgery was 42 ± 7 years. The dominant arm was involved in 58% of cases. Overall, 75% of all patients described their job as requiring “repetitive motion.” Two-thirds (66%) performed work activities that were classified as “heavy manual labor” as defined by the US Department of Labor guidelines (maximum lifting ≥75 lb). Thirty-six percent of patients attributed their condition to an injury or
Discussion
Lateral epicondylitis is a common elbow diagnosis that usually responds to conservative treatment. Operative intervention may be indicated in a small percentage of recalcitrant cases. This study evaluated a surgical technique that we developed to identify and specifically release the origin of the ECRB arthroscopically.7 The goal was to provide clinical outcome data to support our previous anatomic investigations. The results show that adequate clinical outcome and pain relief can be achieved
Conclusions
We found the clinical outcomes of an arthroscopic technique that we developed to accurately release the ECRB tendon origin to be safe and effective for cases of lateral epicondylitis resistant to conservative measures. A small subset of patients do have persistent symptoms, including some who obtain minimal benefit from the procedure. This underscores the importance of preoperative education and careful patient selection.
Disclosure
Anthony A. Romeo receives royalties and research funding and is a consultant for Arthrex. However, none of these funds were applied to or conflicted with this project. Brian J. Cole receives royalties from Arthrex and Stryker. He also consults for Genzyme, Zimmer, DePuy, Arthrex, Carticept, and Regentis. Research support is provided by Arthrex, Zimmer, and DePuy. However, none of these funds were applied to or conflicted with this project.
References (18)
- et al.
Arthroscopic classification and treatment of lateral epicondylitis: two-year clinical results
J Shoulder Elbow Surg
(2000) - et al.
Lateral tennis elbow: "is there any science out there?" J Shoulder Elbow Surg
(1999) - et al.
Lateral epicondylitis: anatomic relationships of the extensor tendon origins and implications for arthroscopic treatment
J Shoulder Elbow Surg
(2008) New surgical approach to lateral epicondylitis of the humerus
Lancet
(1972)- et al.
Arthroscopic release for lateral epicondylitis
Arthroscopy
(2001) - et al.
Elbow arthroscopy: a new technique
Arthroscopy
(1989) - et al.
Tendinosis of the extensor carpi radialis brevis: an evaluation of three methods of operative treatment
J Shoulder Elbow Surg
(2006) Arthroscopic versus open techniques for extensor tenodesis of the elbow
Tech Shoulder Elbow Surg
(2000)- et al.
Long-term follow-up of arthroscopic treatment of lateral epicondylitis
Am J Sports Med
(2008)
Cited by (96)
Modified arthroscopic tenotomy of the extensor carpi radialis brevis for refractory lateral epicondylitis: a cohort study
2024, Journal of Shoulder and Elbow SurgeryArthroscopic Extensor Carpi Radialis Brevis Muscle Resection for Chronic Elbow Lateral Epicondylitis
2023, Arthroscopy TechniquesWide Range in Complication Rates Following Elbow Arthroscopy in Adult and Pediatric Patients: A Systematic Review
2023, Arthroscopy - Journal of Arthroscopic and Related SurgeryOpen procedure vs. arthroscopic débridement for chronic medial epicondylitis
2023, Journal of Shoulder and Elbow SurgeryNo Difference in Complication or Reoperation Rates Between Arthroscopic and Open Debridement for Lateral Epicondylitis: A National Database Study
2023, Arthroscopy - Journal of Arthroscopic and Related SurgeryThe role of the lateral collateral ligament-capsule complex of the elbow under gravity varus
2023, Journal of Shoulder and Elbow Surgery