Outcomes of Continued Intensive Conservative Treatment Versus Arthroscopic Extensor Carpi Radialis Brevis Release for Recalcitrant Lateral Epicondylitis: A Non-randomized Controlled Trial.

Abstract

There is no consensus on treatment of recalcitrant lateral epicondylitis (RLE). This is a prospective, non-randomized, interventional study comparing pain scores and functional outcomes between arthroscopic extensor carpi radialis brevis release and continued intensive conservative treatment. The study compared two groups: Group 1, consisting of 25 patients undergoing continued conservative treatment for 24months, and Group 2, consisting of 25 patients undergoing arthroscopic extensor carpi radialis brevis release with decortication (ARD). VAS (Visual Analogue Scale) score for lateral elbow pain at rest and after routine daily activities were compared at 6weeks, 24weeks, 12months and 24months. Functional outcomes were compared with grip strength, and patients reported functional outcome scores, pre-intervention and 24months post-intervention. There was a significant improvement in VAS scores for pain, functional outcome scores, and grip strength in both the groups post-intervention (P < 0.05). VAS scores for pain at rest in both the groups were significantly better after the interventions, at all follow-up durations (P < 0.001). VAS scores for pain after routine daily activities were significantly better in group 2 at 24weeks (P = 0.002) and afterward (P < 0.001).Group 2 had significantly better functional outcome scores at 24months (P < 0.001) though the difference in grip strength was not statistically significant (P = 0.121). The present study shows favourable functional outcomes and pain scores of ARD compared to continued intensive conservative treatment for RLE. II, Non-randomized comparative study. The online version contains supplementary material available at 10.1007/s43465-022-00649-w.