1. Clinical results of arthroscopic release or open release
in combined medial and lateral epicondylitis
Kee Baek Ahn, MD, In Hyeok Rhyou, MD.
Introduction
Epicondylitis
Lateral epicondylitis 1-3% / Medial epicondylitis 0.4–0.6%
Self-limiting within 12 months. but, 4-11% require surgical treatment
Symptoms and Physical Exam
Pain & local Tenderness over lateral and medial epicondyle
Provocative test
- Lateral epicondylitis with resisted wrist extension
- Medial epicondylitis with resisted pronation & wrist flexion]
Treatment
 Rest & NSAIDs
 Physical therapy (stretching,strengthening)
 Brace(counterforce, power trap)
 ESWT
 Injection(steroid, PRP)
 Surgery (open or arthroscopic)
Cases
Case #1 : F/45, Rt. Elbow pain. Sx. Duration: 30months
Arthroscopic Tendon Release
POD 1yr follow up
Case #2 : F/50, Rt. Elbow pain. Sx. Duration: 12months
Open Tendon Release
Purpose of study
To compare the clinical outcomes of patients who underwent open or arthroscopic release in combined medial and lateral epicondylitis.
Materials and methods
from 2011 to 2016, 11 patients with lateral and medial epicondylitis who did not respond to conservative management for more than 6 months were included.
Clinical Scores : pain VAS, MMES, DASH
Open Release
A/S Release
Age
52.6
46.3
Sx. duration
16.8 months
15.5 months
case 8 3
Discussion
Arthroscopic surgical treatment for medial epicondylitis of the elbow exhibits good out- comes and is safe and effective.1
- No significant complications were observed when the
procedure was performed via arthroscopy.
Both a traditional open approach and the newer arthroscopic method provide an effective treatment of recalcitrant TE without major complications. The arthroscopic method offers a small, but not insignificant, improvement in the outcome as evaluated by the Quick DASH score.2
Results
Clinical Scores, Preoperative vs 6months after surgery
References
do Nascimento MD, A. T., & MD, G. K. C. (2017). Arthroscopic surgical treatment of medial epicondylitis. Journal of Shoulder and Elbow Surgery, 26(12), 1–4.
D, E. S. M. D. P., M, J. H. M., & D, J. Ø. P. (2013). Arthroscopic Versus Open Tennis Elbow Release: 3- to 6-Year Results of a Case-Control Series of 305 Elbows. Yjars, 29(5), 854–859.
Conclusions
Arthroscopic or open release for recalcitrant lateral and medial epicondylitis is effective , reliable procedures.
Arthroscopic release is more advantageous regarding cosmesis.
Upper Extremity and Microsurgery Center
Pohang Semyeong Christianity Hospital, South Korea