Objective: To analyze the short-term effectiveness of repairing musculus extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) tendon using suture anchor after debridement of extensor tendon insertion for recalcitrant lateral epicondylitis.
Methods: Between March 2009 and May 2011, 10 patients (10 elbows) with recalcitrant lateral epicondylitis received repair of the ECRB and EDC tendon to the lateral epicondyle using a single suture anchor after debridement of extensor tendon insertion. There were 6 males and 4 females with an average age of 45.4 years (range, 36-57 years). The dominant elbow was involved in 8 patients and nondominant elbow in 2 patients; there were 4 manual workers and 6 ordinary workers. The disease duration ranged from 8 to 24 months (mean, 12.3 months). All patients had epicondylus lateralis humeri pain, local swelling and tenderness, and positive Mill sign. The average elbow range of motion (ROM) was 11.3 degrees (range, 0-30 degrees) in extension and was 132.5 degrees (range, 120-145 degrees) in flexion. Preoperative MRI showed external humeral epicondylitis in all patients.
Results: Primary wound healing was obtained in all patients without complications of infection, leakage of joint fluid, and stiffness of elbow. Ten patients were followed up 4 to 23 months with an average of 12 months (more than 12 months in 7 cases). The time to return to work was (3.75 +/- 0.95) months for manual workers and was (2.91 +/- 0.20) months for ordinary workers, showing no significant difference (t = 1.715, P = 0.180). Compared with preoperation, the mean visual analogue scale (VAS) score significantly decreased (P < 0.05), and Mayo score and the grip strength of dominant and nondominant significantly increased (P < 0.05), but no significant difference was found when compared with non-surgical side at last follow-up (P > 0.05). At last follow-up, the average ROM was -1.5 degrees (range, 0-10 degrees) in extension and was 150.5 degrees (range, 140-160 degrees) in flexion.
Conclusion: To suture anchor for repairing the ECRB and EDC after debridement is a satisfactory procedure to treat recalcitrant lateral epicondylitis. It can effectively prevent loss of the forearm extensor strength, relieve the pain, recover the grip strength, and obtain good results.