Arthroscopic lateral capsule resection is enough for the management of lateral epicondylitis

Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):2000-2005. doi: 10.1007/s00167-020-06255-3. Epub 2020 Sep 1.

Abstract

Purpose: Controversy exists with regards to the etiology and treatment of lateral epicondylitis and the role of the lateral capsule in this pathology. The aim of this study was to compare arthroscopic lateral capsule resection with or without extensor carpi radialis brevis (ECRB) tendon debridement for treatment of lateral epicondylitis.

Methods: This is a retrospective study of 38 patients who underwent arthroscopic surgery for LE with two different techniques: Eighteen patients were treated with arthroscopic lateral capsular resection (LCR) + ECRB debridement and 20 patients were treated with arthroscopic LCR alone, without ECRB debridement. Both groups were assessed with Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score for function and Visual Analog Scale (VAS) score for pain.

Results: Quick DASH scores were 12 [Formula: see text] 5 and 13 [Formula: see text] 4 at Groups 1 and 2, respectively, without any statistically significant difference. VAS pain scores were 15 [Formula: see text] 2 for both groups. VAS function scores were 85 [Formula: see text] 22 and 86 [Formula: see text] 18 at Groups 1 and 2 respectively. Sick leave periods in terms of weeks were 7 [Formula: see text] 5 and 7 [Formula: see text] 4 at Groups 1 and 2, respectively. There was no statistically significant difference in outcome of the two groups compared in terms of VAS pain, function scores, failure (re-operation) rates and sick leave period at the end of final follow-up.

Conclusion: Both arthroscopic LCR alone and Arthroscopic LCR with ECRB debridement for the management of refractory LE provide significant improvement in pain and function. Isolated Arthroscopic LCR could be a sufficient surgical treatment for refractory LE. Thus, ECRB debridement or release may not be necessary in every case.

Level of evidence: IV.

Keywords: Capsular resection; Debridement; Elbow arthroscopy; Extensor tendon; Lateral epicondylitis; Tennis elbow.

MeSH terms

  • Adult
  • Arthroscopy / methods*
  • Debridement
  • Elbow / physiopathology
  • Elbow / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Retrospective Studies
  • Tennis Elbow / physiopathology
  • Tennis Elbow / surgery*
  • Treatment Outcome