Assessment of the Functional and Clinical Outcomes of Arthroscopic Release of Extensor Carpi Radialis Brevis in Management of Chronic Lateral Epicondylitis

K. Hal *

Department of Orthopedic Surgery, Suez Canal University, Egypt.

M. El Hady

Department of Orthopedic Surgery, Suez Canal University, Egypt.

M. Rakha

Department of Orthopedic Surgery, Suez Canal University, Egypt.

S. Sokar

Department of Orthopedic Surgery, Suez Canal University, Egypt.

*Author to whom correspondence should be addressed.


Abstract

Background: Lateral epicondylitis commonly known as tennis elbow, is one of the commonest causes of elbow pain and dysfunction. It is due to excessive use of the muscles of the back of the forearm. Histological findings include granulation tissue and micro-rupture, degenerative changes with no traditional inflammation. Nowadays, management of tennis elbow is achieved through arthroscopy for release of extensor carpi radialis brevis (ECRB) tendon.

Aim: To improve the quality of life of chronic lateral epicondylitis patients.

Subjects and Methods: This study was Quasi experimental study where Twenty-five patients with chronic lateral epicondylitis were enrolled in the study and were subjected to history taking, physical examination, and then they underwent arthroscopic release of (ECRB) tendon for management of chronic lateral epicondylitis. Outcomes were assessed by Nirschl tennis elbow score and DASH scoring system.

Results: A total of 25 patients with mean age of 43.5± 6.6 years and 44% were males. Sixty-eight percent of them had no comorbidities. Ninety-six percent of the participants had history of previous steroid injections with the mean of 1.8± 0.8. There was statistically decrease in DASH score among patients after 6 and 12 weeks of operation than preoperative (p <0.001). Also, there was statistically significant improvement in the NIRSCHL score among patients after 6 and 12 weeks compared to preoperative score (P <0.001). Postoperative complications were reported among only 2 patients.

Conclusion: We suggested that arthroscopic release of extensor carpi radialis brevis is effective in management of chronic lateral epicondylitis as it is improving function and decreasing impairment. So, we consider extensor carpi radialis brevis tendon release is a good option for treatment of lateral epicondylitis with minimal complications.

Keywords: Tennis elbow, elbow arthroscopy, lateral epicondylitis, arthroscopic release


How to Cite

Hal , K., El Hady , M., Rakha , M., & Sokar , S. (2023). Assessment of the Functional and Clinical Outcomes of Arthroscopic Release of Extensor Carpi Radialis Brevis in Management of Chronic Lateral Epicondylitis. Asian Journal of Orthopaedic Research, 6(2), 45–52. Retrieved from https://journalajorr.com/index.php/AJORR/article/view/167

Downloads

Download data is not yet available.

References

Hubbard MJ, Hildebrand BA, Battafarano MM, Battafarano DF. Common Soft Tissue Musculoskeletal Pain Disorders. Prim Care. 2018;45(2):289-303. DOI: 10.1016/j.pop.2018.02.006. PMID: 29759125.

Descatha A, Albo F, Leclerc A, Carton M, Godeau D, Roquelaure Y, Petit A, Aublet-Cuvelier A. Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis. Arthritis Care Res (Hoboken). 2016;68(11):1681-1687. DOI: 10.1002/acr.22874. PMID: 26946473.

McShane JM, Shah VN, Nazarian LN. Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow: Is a corticosteroid necessary? J Ultrasound Med. 2008;27(8):1137-44.

DOI: 10.7863/jum.2008.27.8.1137. PMID: 18645071

Krogh TP, Bartels EM, Ellingsen T, Stengaard-Pedersen K, Buchbinder R, Fredberg U, Bliddal H, Christensen R. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials. Am J Sports Med. 2013;41(6):1435-46. DOI: 10.1177/0363546512458237. Epub 2012 Sep 12. PMID: 22972856.

Szabo SJ, Savoie FH 3rd, Field LD, Ramsey JR, Hosemann CD. Tendinosis of the extensor carpi radialis brevis: An evaluation of three methods of operative treatment. J Shoulder Elbow Surg. 2006; 15(6):721-7.

DOI: 10.1016/j.jse.2006.01.017. Epub 2006 Sep 11. PMID: 16963287.

Zayed F. Comparative Study: Arthroscopic Versus Open Tennis Elbow Release. Al-Azhar International Medical Journal. 2020;0(0).

Soeur L, Desmoineaux P, Devillier A, Pujol N, Beaufils P. Outcomes of arthroscopic lateral epicondylitis release: Should we treat earlier? Orthop Traumatol Surg Res. 2016;102(6):775-80. DOI: 10.1016/j.otsr.2016.05.017. Epub 2016 Aug 31. PMID: 27591940.

Lattermann C, Romeo AA, Anbari A, Meininger AK, McCarty LP, Cole BJ, Cohen MS. Arthroscopic debridement of the extensor carpi radialis brevis for recalcitrant lateral epicondylitis. J Shoulder Elbow Surg. 2010;19(5):651-6.

DOI: 10.1016/j.jse.2010.02.008. PMID: 20541097.

Lee SY, Kim W, Lim C, Chung SG. Treatment of lateral epicondylosis by using allogeneic adipose-derived mesenchymal stem cells: A pilot study. Stem Cells. 2015;33(10):2995-3005. DOI: 10.1002/stem.2110. Epub 2015 Aug 6. PMID: 26202898.

Fahmy FS, ElAttar M, Salem HF. Hand-grip strength and return to heavy manual Work at a mean 5-year follow-up after arthroscopic release of recalcitrant lateral epicondylitis. Orthopaedic Journal of Sports Medicine. 2022;10(2).

DOI:10.1177/23259671221078586.

Mohamed M, Zaghlool A, Addosooki A, Khalifa A. Functional outcome of arthroscopic release of extensor carpi radialis brevis muscle in treatment of chronic lateral epicondylitis (tennis elbow). Egyptian Journal of Orthopedic Research, 2021; 2(1): 39-46. DOI: 10.21608/ejor.2021.175573.

Colombi R, Bevand A, Devillier A, Baulot E, Ezzahoui A, Martz P. Exclusive posterolateral arthroscopic and endoscopic approaches used in the treatment of lateral epicondylitis. Orthopedics. 2019;42(6): e521-e527.

DOI: 10.3928/01477447-20191001-03. Epub 2019 Oct 7. PMID: 31587076