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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Background: Osteoarthritis is a condition that impacts all of the tissues in a joint. Evidence suggests that the subchondral bone is the most important component in both pain genesis and disease progression Aim of the study: Prospective outcome research to see how effective is subchondroplasty surgery at relieving pain and improving knee function in patients having osteoarthritis-related bone marrow lesions of the knee. Patients and Methods:The study included 30 patients between the ages of 40 and 75 who had been suffering from atraumatic knee pain for at least three months, had failed conservative treatment for at least three months, had BML on MRI imaging in a loading area, and had localized pain in the BML area. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and visual analog scale (VAS) pain scores have been acquired preoperatively, at 2 weeks, 3 months, 6 months, and 12 months after surgery. Under fluoroscopic guidance, subchondroplasty was conducted by injecting nanocrystal hydroxyapatite cement into the bone marrow lesion's location.Results: Following a one-year follow-up, the WOMAC scores improved considerably, from 62.03+-11.19 to 21.83 +-8.18 (p < 0.001). All of the patients' pain, stiffness, and physical functions improved significantly. Furthermore, after surgery, the mean VAS values showed a considerable improvement. At the end of the year, the patient improved from 6.98 +-1.16 to 1.81 +-1.00 (p < 0.01), which is highly statistically significant. Conclusion: Subchondroplasty is a promising approach for treating osteoarthritis-related bone marrow lesions of the knee, providing significant pain relief and functional results with low rates of complications in the short term results.

Background Baker's cysts have a significant functional impact in patients with knee osteoarthritis (KOA), which in turn made its detection an important issue. Despite the impact of these cysts, clinical diagnosis remains of low sensitivity which raises the possibility of subclinical cysts. Objectives Estimate the subclinical presence of popliteal cyst and its impact on functional limitation in patients with KOA. Methods Study was carried out on 444 patients with primary KOA, grade III according to kellgren and Lawrence scale with absence of any clinical signs suggesting the presence of Baker's cyst. Knee functional status was assessed using KOOS scale for Pain, other Symptoms, Activities of Daily Living (ADL), Sport and Recreation Function (Sport/Rec) and knee-related Quality of Life (QOL). All patients were assessed by Ultrasound and power Doppler for detection of Baker's cyst. Results US showed that 396 (89.2%) patients out of 444 had no Bakers cyst and they represent group one, on the other hand bakers cyst detected in 48 (10.8%) patients which represent group two. Comparison of both groups shows that KOOS scale parameters was significantly higher in group one than group two, as t was 9.4 for Pain, 8.2 for Symptom, 10.1 for ADL, 17.9 for Sport/Rec, and 11.3 for QOL and p<0.001. On the other hand a significant negative correlation was found between the cyst size and the KOOS parameters where r was -0.794, -0.702, -0.653, -0.448, -0.607 for Pain, Symptom, ADL, Sport/Rec, and QOL respectively and p<0.001. Conclusions According to our results Baker's cysts appears to be frequently present subclinically and its subclinical presence was associated with highly significant functional limitation of the Knee joint. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.1144

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