Arthroscopic Release for Lateral Epicondylitis: A Cadaveric Model

Kuklo, Timothy R.; Taylor, Kenneth F.; Murphy, Kevin P.; Islinger, Richard B.; Heekin, R. David; Baker, Champ L.

doi:10.1016/s0749-8063(99)70031-9

Cited by 94 publications

(46 citation statements)

References 19 publications

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“…Results have been reported for many different applications, including osteophyte debridement for posteromedial impingement, loose body removal, capsular release, treatment of osteochondritis dissecans, and debridement for lateral epicondylitis, as well as debridement for degenerative joint disease and other problems not directly related to the athlete's elbow [40][41][42][43][44][45][46][47][48].…”

Section: Resultsmentioning

confidence: 99%

The Thrower's Elbow: Arthroscopic Treatment of Valgus Extension Overload Syndrome

O’Holleran¹,

Altchek

2006

HSS Jrnl

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Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications will be reviewed.

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Section: Resultsmentioning

confidence: 99%

The Thrower's Elbow: Arthroscopic Treatment of Valgus Extension Overload Syndrome

O’Holleran¹,

Altchek

2006

HSS Jrnl

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“…3). Several studies have reported early pain relief and return to work [2,11,19,20] (Table 4). We found most patients returned to their jobs without difficulties approximately 12 weeks postoperatively, taking longer than the 2.2 weeks reported by Baker et al [2].…”

Section: Discussionmentioning

confidence: 99%

Is Posterior Synovial Plica Excision Necessary for Refractory Lateral Epicondylitis of the Elbow?

Rhyou

Kim

2013

Clinical Orthopaedics &Amp; Related Research

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Background Arthroscopic treatments for lateral epicondylitis including débridement of the extensor carpi radialis brevis (ECRB) origin (Baker technique) or resection of the radiocapitellar synovial plica reportedly improve symptoms. However the etiology of the disease and the role of the plica remain unclear. Results Two years postoperatively, we found no differences in the VAS pain score or DASH: the mean VAS pain scores were 0.3 points in Group A and 0.4 points in Group B, and the DASH scores were 5.1 points and 6.1 points respectively. Conclusions The addition of débridement of the posterior synovial fold did not appear to enhance either pain relief or function compared with the classic Baker technique without decortication. Level of Evidence Level III, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.

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“…Care is taken not to incise the inferior anterior capsule and ECRB tendon below the equator of the radiocapitellar joint, ensuring that the dissection and release avoid injury to the adjacent lateral collateral ligament complex. 8,9 After release of the ECRB tendon, a 4.5-mm full-radius arthroscopic shaver (Smith & Nephew, Andover, MA) is placed directly through the tennis-elbow portal (Fig 5), and the released ECRB is excised for approximately 1 cm distally until healthyappearing ECRB tendon is visualized (Fig 6). Adequate arthroscopic visualization is almost always possible using the 30 arthroscope, with the 70 arthroscope used very sparingly.…”

Section: Surgical Techniquementioning

confidence: 99%

Arthroscopic Lateral Epicondylitis Release Using the “Bayonet” Technique

Stiefel

Field

2014

Arthroscopy Techniques

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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.

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Arthroscopic Release for Lateral Epicondylitis: A Cadaveric Model

Cited by 94 publications

References 19 publications

The Thrower's Elbow: Arthroscopic Treatment of Valgus Extension Overload Syndrome

The Thrower's Elbow: Arthroscopic Treatment of Valgus Extension Overload Syndrome

Is Posterior Synovial Plica Excision Necessary for Refractory Lateral Epicondylitis of the Elbow?

Arthroscopic Lateral Epicondylitis Release Using the “Bayonet” Technique

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