Tratamiento artroscópico versus tratamiento mediante cirugía abierta de la epicondilitis lateral. Estudio de cohortes prospectivo

Abstract

PurposeTo compare the results between arthroscopic and open surgery in the treatment of lateral epicondylitis. MethodsA prospective cohort study was conducted on 30 patients treated with lateral epicondylitis, in which rehabilitation treatment during 3 months had failed. They were distributed into 2 groups: open surgery and arthroscopic surgery. ResultsThe mean age of the patients was 47.63±1.19, 17 women and 13 men, with a mean follow-up time of 69.07±4.01 days. Preoperative pain (visual analogue scale (VAS) 9.27±0.12) decreased (p<.001) with both techniques a week after surgery (7,33±0,25 in open surgery and 3.40±0.21 in arthroscopic) and at the time of discharge (2.00±0.20 in open surgery and 1.33±0.16 in arthroscopic), this decline being significantly higher one week after surgery (p<.001), and at the time of discharge (p=.03) in arthroscopic surgery than in open surgery. Pre-operative functionality (Mayo Elbow Performance Score (MEPS) 45.00±0.98 in open surgery and 44.00±0.87 in arthroscopic surgery) significantly improved (p<.001) in both groups after surgery (87.67±1.45 in open surgery and 90.33±1.98 in arthroscopic surgery), with no significant differences between the two groups. The time to discharge for the return to work activity was significantly lower (p=.004) in arthroscopic surgery (58.87±4.15 days) than in open surgery (79.27±5.88 days). ConclusionsIn patients with lateral epicondylitis, pain and functionality improved with both techniques. Relief of pain was greater with arthroscopic surgery than with open surgery, with no significant differences in functionality scores at the time of discharge between the two groups. Post-operative time to discharge was significantly lower with arthroscopic surgery than with open surgery. Level of evidenceII. Clinical relevanceArthroscopic surgery of lateral epicondylitis achieves as good functional results, but with less pain, and also an earlier return to work activity than open surgery.