Arthroscopic Release of Resistant Tennis Elbow

Abstract

Background: Lateral epicondylitis is a common cause of lateral elbow pain; characterized as an overuse injury of the forearm and the wrist extensors. The elbow arthroscopy has an important role for diagnosing and treating many elbow disorders. Objective: The aim of this study was to evaluate the effectiveness of the arthroscopic intervention as a minimally invasive procedure in management of resistant cases with tennis elbow after failure of conservative treatment. Material and methods: A prospective study included 30 patients with resistant lateral epicondylitis treated with arthroscopic debridement of extensor carpi radialis brevis tendon. This study was carried out in the period between January 2017 and February 2019 at Al Azhar University Hospitals. The patients were evaluated pre-, intraand post-operatively for their elbow function and pain using the following scores: Mayo Elbow Performance Index (MEPI), Disability of the Arm, Shoulder and Hand (DASH), The Nirschl staging score and visual analog scale (VAS) for pain. Result: A total of 30 patients (12 male and 18 female) were included. The mean of MEPI score improved from 71.33 to 92.55, DASH score from 28.53 to 3.18, Nirschl scale improved from 4.13 to 1.47 and pain VAS improved from 5.27 to 1.47. There was a significant difference between from before to after surgery for the four functional scores. 2 patients complicated with ulnar nerve injury. Conclusion: The arthroscopic treatment of tennis elbow was shown to be an effective therapeutic option when appropriately indicated and performed in refractory cases. It also allowed excellent viewing of joint space for diagnosis and treatment of any associated pathological conditions with a minimally invasive procedure.