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

Abstract

PurposeControversy 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. MethodsThis 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. ResultsQuick DASH scores were 12 ± 5 and 13 ± 4 at Groups 1 and 2, respectively, without any statistically significant difference. VAS pain scores were 15 ± 2 for both groups. VAS function scores were 85 ± 22 and 86 ± 18 at Groups 1 and 2 respectively. Sick leave periods in terms of weeks were 7 ± 5 and 7 ± 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. ConclusionBoth 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 evidenceIV.

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

“…Previous studies reported successful results with only simple debridement or capsule resection. 23 24) Therefore, incomplete removal of tendinosis may not be an important factor for clinical outcomes.…”

Application of ultrasound in avoiding radial nerve injury during elbow arthroscopy: a retrospective follow-up study

“…Previous studies [ 6 , 7 , 24 ] have demonstrated that the radial nerve is prone to injury during the anterolateral approach in elbow arthroscopy. The radial nerve is directly anterior to the radial head, and the anterolateral portal is located anterior to the articulation of the humeroradial joint [ 25 ]. Thaveepunsan et al [ 26 ] reported a needle-and-knife technique for anterolateral portal placement during elbow arthroscopy.…”

Elbow Arthroscopy

“…Debridement of the lateral condylar ridge and epicondyle to stimulate a bleeding response at the common extensor origin has shown good results with resolution of lateral epicondylitis symptoms. In addition, lateral capsular resection in isolation has shown promising results for relief of lateral epicondyle symptoms 15 .…”

“…Loose body removal, OCD fixation, microfracture, synovectomy, radiocapitellar plica excision, osteophyte excision, and capsular releases are all indications for elbow arthroscopy. Arthroscopic debridement of the common extensor tendon for lateral epicondylitis has also been reported 15 . Contraindications for elbow arthroscopy primarily focus on abnormal anatomic findings.…”