Skip to main content
SpringerLink
Log in

Arthroscopic versus percutaneous release of common extensor origin for treatment of chronic tennis elbow

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Lateral epicondylitis is a common orthopedic problem. Rest, activity modification, and conservative therapies are generally efficacious in relieving symptoms in the majority of patients; however, a small percentage of people will experience refractory pain and require surgical intervention to alleviate their discomfort. Surgical release of the common extensor origin can be done through an open, percutaneous, or arthroscopic approach.

Patients and methods

This prospective study includes 33 patients with chronic resistant lateral epicondylitis who had received conservative treatment including modification of activity and 2 injections of 80 mg of hydrocortisone, for more than 6 months, aiming to compare two different techniques of treatment. The first group included 14 patients with a mean age of 42 years treated by arthroscopic release of common extensor origin.

The second group included 19 patients with a mean age of 48 years treated by percutaneous tenotomy. The mean follow up was 12 months for the arthroscopic group and 10 months for the percutaneous tenotomy group.

Results

The results were evaluated according to the Disabilities of the Arm, Shoulder and Hand (DASH) score and the visual analogue scale (VAS). In the first group (treated by arthroscopy), the average DASH score improved from 72 to 48 and the average VAS improved from 9.1 to 2. In the second group (treated by percutaneous tenotomy), the average DASH score improved from 70 to 50 and the average VAS improved from 9 to 2.1. Concerning patient satisfaction after surgery, in the first group 7 patients (50%) were pleased, 6 (42.85%) were satisfied and 1 case (7.14%) was not satisfied. In the second group, 7 patients (36.84%) were pleased, 10(52.63%) were satisfied and 2 cases (10.52%) were not satisfied.

Conclusion

Both arthroscopic and percutaneous release of the common extensor origin can be effective in treatment of lateral epicondylitis. Arthroscopic treatment of lateral epicondylitis gives more favorable results than percutaneous tenotomy. Although technically more difficult than percutaneous tenotomy, arthroscopy has the advantage of visualization of the pathology and much better improvement of elbow functions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Nirschl RP, Ashman ES (2003) Elbow tendinopathy: tennis elbow. Clin Sports Med 22:813–836

    Article  PubMed  Google Scholar 

  2. Mishra A, Pavelko T (2006) Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 34:1774–1778

    Article  PubMed  Google Scholar 

  3. Everts PA, Devilee RJ, Brown Mahoney C (2008) Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome. A prospective randomized double-blind study. Eur Surg Res 40:203–210

    Article  CAS  PubMed  Google Scholar 

  4. Boyd HB, McLeod AC Jr (1973) Tennis elbow. J Bone Joint Surg [Am] 55A:1183–1187

    Google Scholar 

  5. Posch JN, Goldberg VM, Larrey R (1978) Extensor fasciotomy for tennis elbow: a long-term follow-up study. Clin Orthop 135:179–182

    PubMed  Google Scholar 

  6. Anthony AR, Mihael Pensak BS, Shane JN, Nicole AF, Mark SC, Brian JC (2010) Arthroscopic treatment of lateral epicondylitis: techniques in shoulder and elbow surgery. http://www.Shoulderelbowsurgery.com

  7. Lo MY, Safran MR (2007) Surgical treatment of lateral epicondylitis: a systematic review. Clin Orthop Relat Res 463:98–106

    PubMed  Google Scholar 

  8. Nirschl RP, Pettrone FA (1979) Tennis elbow. J Bone Joint Surg 61A:832–839

    Google Scholar 

  9. Verhaar J, Walenkamp G, Kester A, Mameren HV, Linden TVD (1993) Lateral extensor release for tennis elbow: a prospective long term follow up study. J Bone Joint Surg 75A:1034–1043

    Google Scholar 

  10. Keizer SB, Rutten HP, Pilot P, Morre HHE, Os JJ, Verburg AD (2002) Botulinum toxin injection versus surgical treatment for tennis elbow. Clin Orthop 401:125–131

    Article  PubMed  Google Scholar 

  11. Dunkow PD, Jatti M, Muddu BN (2004) Comparison of open and percutaneous techniques in the surgical treatment of tennis elbow. J Bone Joint Surg (Br) 86B:701–704

    Article  Google Scholar 

  12. Grundberg AB, Dobson JF (2000) Percutaneous release of the common extensor origin for tennis elbow. Clin Orthop 376:137–140

    Article  PubMed  Google Scholar 

  13. Baumgard SH, Schwartz DR (1982) Percutaneous release of the epicondylar muscles for humeral epicondylitis. Am J Sports Med 10:233–236

    Article  CAS  PubMed  Google Scholar 

  14. Peart RE, Strickler SS, Schweitzer KM (2004) Lateral epicondylitis: a comparative study of open and arthroscopic lateral release. Am J Orthop 33:565–567

    PubMed  Google Scholar 

  15. Stapleton T Jr, Baker CL Jr (1996) Arthroscopic treatment of lateral epicondylitis: a clinical study. Arthroscopy 12:365–366

    Google Scholar 

  16. Baker CL, Murphy KP, Gottlob CA, Curd DT (2000) Arthroscopic classification and treatment of lateral epicondylitis: two year clinical results. J Shoulder Elbow Surg 9:475–482

    Article  PubMed  Google Scholar 

  17. Owens BD, Murphy KP, Kuklo TR (2001) Arthroscopic release for lateral epicondylitis. Arthroscopy 17:582–587

    Article  CAS  PubMed  Google Scholar 

  18. Mullett H, Sprague M, Brown G, Hausman M (2005) Arthroscopic treatment of lateral epicondylitis: clinical and cadaveric studies. Clin Orthop 439:123–128

    Article  CAS  PubMed  Google Scholar 

  19. Rubenthaler F, Wiese M, Senge A, Keller L, Wittenberg RH (2005) Long term follow up of open and endoscopic Hohmann procedures for lateral epicondylitis. Arthroscopy 21:684–690

    Article  PubMed  Google Scholar 

  20. Szabo SJ, Savoie FH III, Field LD, Ramsey JR, Hosemann CD (2006) Tendinosis of extensor carpi radialis brevis: an evaluation of three methods of treatment. J Shoulder Elbow Surg 15:721–727

    Article  PubMed  Google Scholar 

  21. Lattermann C, Romeo A, Anbari A, Menininger A, McCarty P, Cole B, Cohen S (2010) Arthroscopic debridement of the extensor carpi radialis brevis for recalcitrant lateral epicondylitis. J Shoulder Elbow Surg 19:651–656

    Article  PubMed  Google Scholar 

  22. Savoie F, VanSice W, O’Bbrien M (2010) Arthroscopic tennis elbow release. J Shoulder elbow Surg 19:31–36

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, El-Minia University, El-Minia, Egypt

    Ahmed Mohamed Ahmed Othman

Authors
  1. Ahmed Mohamed Ahmed Othman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed Mohamed Ahmed Othman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Othman, A.M.A. Arthroscopic versus percutaneous release of common extensor origin for treatment of chronic tennis elbow. Arch Orthop Trauma Surg 131, 383–388 (2011). https://doi.org/10.1007/s00402-011-1260-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-011-1260-2

Keywords

Search

Navigation