Outcomes of arthroscopic lateral epicondylitis release: Should we treat earlier?

Soeur, L.; Desmoineaux, P.; Devillier, Alexandre; Pujol, Nicolas; Beaufils, Philippe

doi:10.1016/j.otsr.2016.05.017

Cited by 15 publications

(8 citation statements)

References 33 publications

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“…3 The rationale of surgery is removal of the degenerated tissue to enhance the vascularity, bring more growth factors, and induce new collagen synthesis. 18 The main issues with open surgery are iatrogenic posterolateral instability, missing any intra-articular lesions, One-way analysis of variance.…”

Section: Discussionmentioning

confidence: 99%

“…3 The rationale of surgery is removal of the degenerated tissue to enhance the vascularity, bring more growth factors, and induce new collagen synthesis. 18…”

Section: Discussionmentioning

confidence: 99%

“…15,16 Over 80% of patients respond well to nonoperative measures such as activity modification, physical therapy, nonsteroidal anti-inflammatory drugs, a brace, extracorporeal shock wave therapy, and local injection of corticosteroids or platelet-rich plasma. 18 These measures should be tried for at least 6 months before considering operative intervention. 3,10 Surgery is reserved for recalcitrant cases and failed nonoperative management.…”

mentioning

confidence: 99%

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Hand-Grip Strength and Return to Heavy Manual Work at a Mean 5-Year Follow-up After Arthroscopic Release of Recalcitrant Lateral Epicondylitis

Fahmy

ElAttar

Salem

2022

Orthopaedic Journal of Sports Medicine

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Background: Lateral epicondylitis of the elbow is a common degenerative disorder in middle-aged patients. Surgery is reserved for patients who do not respond to nonoperative treatment. Purpose: To evaluate hand-grip strength and return to heavy manual activities in patients engaged in work requiring heavy lifting after arthroscopic release of refractory lateral epicondylitis. Study Design: Case series; Level of evidence, 4. Methods: The study included consecutive patients who underwent arthroscopic release of the extensor carpi radialis brevis tendon to treat recalcitrant lateral epicondylitis of the elbow, with a minimum 48-month follow-up. Functional outcome measures included assessment of hand-grip strength, visual analog scale for pain, and Mayo elbow performance score. The recorded measurements were compared at postoperative 1 and 6 months and the final assessment. Pre- and postoperative data were compared using the paired t test, and the various postoperative assessments were compared using 1-way analysis of variance. Results: A total of 22 patients (mean ± SD; age, 34.6 ± 5.9 years) with a mean follow-up of 60.5 ± 4.7 months were included in our study. There were highly significant improvements between preoperative and 1-month postoperative results regarding hand-grip strength (17.5 ± 4.1 kg to 34.4 ± 6.8 kg), visual analog scale score for pain (7.86 ± 1.2 to 1.8 ± 1.09), and Mayo score (57.1 ± 7.9 to 89.3 ± 4.9; P < .00001 for all). Significant improvements were found on all 3 functional measures between 1 and 6 months postoperatively ( P ≤ .05 was statistically significant), and there were nonsignificant improvements on all measures from 6-month to final follow-up. The patients regained 96.4% of their hand strength as compared with the unaffected side and returned to their previous activities without reporting serious complications. Conclusion: Minimally invasive arthroscopic release of recalcitrant lateral epicondylitis of the elbow provided a satisfactory functional result, as shown by regaining of hand-grip strength in patients engaged in heavy manual occupations without significant morbidities.

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Section: Discussionmentioning

confidence: 99%

“…3 The rationale of surgery is removal of the degenerated tissue to enhance the vascularity, bring more growth factors, and induce new collagen synthesis. 18…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hand-Grip Strength and Return to Heavy Manual Work at a Mean 5-Year Follow-up After Arthroscopic Release of Recalcitrant Lateral Epicondylitis

Fahmy

ElAttar

Salem

2022

Orthopaedic Journal of Sports Medicine

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“…24,25 As regarding returning to work, the patients after arthroscopic release returned to work earlier than those with open release (5.8 weeks for group-A and 8.8 weeks for group-B) and this was comparable with the results reported by many surgeons. 9,22,[26][27][28][29][30] Care must be taken during arthroscopic tennis elbow release to avoid neurological injuries due to the proximity of important neurological structures especially the ulnar nerve. 31…”

Section: Discussionmentioning

confidence: 99%

Comparative Study: Arthroscopic Versus Open Tennis Elbow Release

Zayed

2020

Al-Azhar International Medical Journal

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Background: Tennis elbow is a very common elbow pathology caused by repetitive trauma over the tendon of Extensor Carpi Radialis Brevis (ECRB) at the common extensor origin. Most cases respond to conservative treatment while resistant cases may need arthroscopic or open surgical release. This study aimed to compare the clinical and functional outcomes of arthroscopic and open release for resistant tennis elbow in selected patients. Patients and Methods: This was a prospective study that was conducted over three years (between 2015 and 2018) and included 30 patients with resistant tennis elbow. The patients were randomized into two equal groups with fifteen patients in each group. The first group (A) had undergone an arthroscopic release while the second group (B) had undergone an open release. All patients were evaluated preoperatively, 3 weeks postoperatively, and 1 year postoperatively using MEPS, DASH Score, and VAS. Results: One year postoperatively, the mean MPES, DASH score, and VAS were improved significantly in both groups. There was no significant difference in the outcome scores between both groups. The average time for return to work was 5.8 ± 2.07 (4-12) weeks for group-A and 8.8 ± 1.97 (7-14) weeks for group-B. There were no significant complications in both groups. Conclusion: Both arthroscopic and open release are similar and effective in the treatment of resistant tennis elbow as noticed by improvement in MEPS, DASH score, and VAS at the end of follow up. The arthroscopic release permits earlier recovery and return to work.

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“…Arthroscopic intracapsular elbow surgery(intracapsular method) refers to an operation in which the natural cavity in the joint capsule is selected as the operate space. To expose the common extensor origin (CEO) outside of the joint capsule under arthroscopy, the capsule is opened from the inside of joint cavity, and the release or debridement is performed near the origin of extensor carpi radialis brevis (ECRB) [11,12]. Intracapsular method soon became the mainstream surgical method for the treatment of refractory tennis elbow because of its minimally invasive nature, safety, and direct vision feature compared with open surgery.…”

Section: Introductionmentioning

confidence: 99%

Evolution of arthroscopic treatment from intracapsular to extracapsular for patients with refractory tennis elbow: A mixed-method study.

Yang¹,

Chu²,

Yuan³

et al. 2020

Preprint

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Background Arthroscopic surgery is widely used in the treatment of refractory tennis elbow due to its advantages of minimally invasive, safe and direct vision. Intra-capsular arthroscopy(intracapsular method), which is performed via natural cavity, is the mainstream arthroscopic procedure. However, intracapsular method requires the damage of joint capsule and may cause intraoperative neurovascular injury and other complications. In view of the defects of intracapsular method, the surgical scheme of the extracapsular arthroscopy (referred to as "extracapsular method") has emerged. The aim of this study was to investigate the exploration history, key theories, methods, and techniques involved in the evolution from the intracapsular method to the extracapsular method for arthroscopic treatment of tennis elbow, and explore the effectiveness and safety of extracapsular method. Methods Qualitative data were collected via focus group interview. 7 surgeons who were selected through purposive sampling discussed on the theories, methods, and technical specifications of the transition from intracapsular method to extracapsular method. Qualitative data were analysed using NVivo11. Quantitative data of consecutive 43 patients were analysed to evaluate the effectiveness and safety of the extracapsular method. Descriptive analysis was conducted to analyse the demographic characteristics and clinical outcomes after surgery. Results The experts agreed that the extracapsular method maintains the integrity of joint capsule and avoids complications caused by joint capsule damage. Extracapsular method was considered easy for surgeons to master and convenient to operate. Technical specifications for extracapsular method were formed based on group discussion. The median time for pain relief and recovery of daily activities of 43 patients treated with these specifications were 3 months and 6 weeks, respectively. The satisfaction rates of Mayo Elbow Performance Scores were 87.2%, 95.6%, and 100% respectively at 3, 6, and 12 months after operation. Conclusion On the basis of international peer innovation, the extracapsular method has been continuously developed in our clinical practice to avoid the possible complications of the intracapsular method. The resulting technical specifications have been shown to have good clinical efficacy and safety in a small sample cohort.

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Outcomes of arthroscopic lateral epicondylitis release: Should we treat earlier?

Abstract: IV, retrospective study.

Cited by 15 publications

References 33 publications

Hand-Grip Strength and Return to Heavy Manual Work at a Mean 5-Year Follow-up After Arthroscopic Release of Recalcitrant Lateral Epicondylitis

Hand-Grip Strength and Return to Heavy Manual Work at a Mean 5-Year Follow-up After Arthroscopic Release of Recalcitrant Lateral Epicondylitis

Comparative Study: Arthroscopic Versus Open Tennis Elbow Release

Evolution of arthroscopic treatment from intracapsular to extracapsular for patients with refractory tennis elbow: A mixed-method study.

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