Advances on open surgery of tennis elbow

Abstract

Currently, surgical treatments in tennis elbow include open, arthroscopic and percutaneous procedures. Open surgery, having definite curative effects, is commonly used. There are different surgical methods based on different hypotheses about the pathogenesis of tennis elbow, such as detachment of common extensor origin, resection of annular ligament, denervation surgery and resection of microvascular nerve bundle. There is a huge difference in open surgery of tennis elbow between China and abroad. Debriding or releasing extensor carpi radialis brevis and common extensor tendon are mostly used abroad though it re-mains controversial whether we should release or debride with tendon, as well as whether it is better to decorticate on lateral epi-condyle or not. In China, tennis elbow is treated with resection of microvascular nerve bundle except for debridement and release of tendon. As for evaluation criteria, the following methods, grip strength, grading system and visual analogue scale have been used in researches. However, cure rate and response rate are valuation criteria for resection of microvascular nerve bundle in China. The evaluation criteria are different among various surgical methods, even in the methods, especially for grading system. Each re-search has unique standards to define excellent, good, fair and poor outcomes. Complications of tennis elbow open surgery are rare, while subcutaneous hematoma is the common complication.