Clinical Outcomes of Arthroscopic Debridement for Lateral Epicondylitis with Partial Injury of the Lateral Collateral Ligament Complex

Abstract

Background: Lateral collateral ligament injuries may occur in patients with chronic lateral epicondylitis. The present study aimed to compare the clinical outcomes of arthroscopic debridement between patients with chronic lateral epicondylitis combined with a partial ligament injury and those without a ligament injury.

Methods: Between 2016 and 2018, patients who underwent arthroscopic debridement for lateral epicondylitis were evaluated. Partial injury to the lateral collateral ligament was defined as discontinuity or thinning with increased signal of the lateral ligament on magnetic resonance imaging and laxity with a firm endpoint in the varus or posterolateral rotatory stress test. Arthroscopic debridement was performed when there was no apparent instability in the stress test under fluoroscopic guidance after anesthesia. Patients with a ligament injury were compared with those without a ligament injury in terms of physical examination (varus stress test and posterolateral rotatory drawer test), pain visual analog scale, Mayo elbow performance score, and quick disabilities of the arm, shoulder and hand score.

Results: There were 38 patients in the intact ligament group and 15 patients in the partial ligament injury group. There were 23 men and 30 women, and the mean patient age was 50 years (range, 27-77 years). The mean follow-up period was 30 months (range, 24-49 months). Instability was not observed in both groups at the last follow-up, and clinical scores improved significantly after surgery. Postoperative results did not show significant difference between the two groups. One patient in the partial injury group underwent revision open debridement owing to persistent pain.

Conclusions: The clinical outcomes of arthroscopic debridement for lateral epicondylitis did not show significant differences between patients with a partial ligament injury and those without a ligament injury.

Keywords: Arthroscopy; Elbow; Instability; Lateral epicondylitis; Tendinopathy.