Arthroscopic Lateral Epicondylitis Release Using the “Bayonet” Technique  Eric C. Stiefel, M.D., Larry D. Field, M.D.  Arthroscopy Techniques  Volume 3, Issue 1, Pages e135-e139 (February 2014) DOI: 10.1016/j.eats.2013.09.006 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 The patient is in the prone position with an arm holder (Weston Arm Holder; Smith & Nephew, Andover, MA) allowing circumferential access to the elbow. The lateral epicondyle is identified after the appropriate bone landmarks have been marked. The lateral tennis-elbow working portal is marked slightly anterior and directly adjacent to the palpable prominence of the lateral epicondyle. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 A 30° arthroscope is used to view from the proximal-anterior medial portal. This is the only viewing portal required to perform the arthroscopic ECRB tendon release. A spinal needle is used for percutaneous localization of the tennis-elbow lateral portal. The oblique entry of the spinal needle should be noted. This will allow sharp dissection of the ECRB from the lateral epicondyle at the tendon's origin. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 With the 30° arthroscope viewing from the proximal-anterior medial portal and following the trajectory established with the spinal needle, a No. 15 blade scalpel is used to incise the skin and release the ECRB tendon along the anterior cortical margin of the lateral epicondyle. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 As viewed through the proximal-anterior medial portal with a 30° arthroscope, the ECRB has been released from its insertion on the lateral epicondyle. After the ECRB has been circumferentially released and debrided, the extensor carpi radialis longus (ECRL) muscle fibers become visible, as shown. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 As viewed through the proximal-anterior medial portal with the 30° arthroscope, a 4.5-mm full-radius arthroscopic shaver (Smith & Nephew) is placed directly through the tennis-elbow portal and used to debride the ECRB tissue. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 As viewed through the proximal-anterior medial portal with the 30° arthroscope, the arthroscopic probe is shown, palpating the leading edge of the ECRB tendon, which has been released and resected from its origin on the lateral epicondyle. Arthroscopy Techniques 2014 3, e135-e139DOI: (10.1016/j.eats.2013.09.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions