Outcome of Percutaneous Release of the Common Extensor Origin for Tennis Elbow
Asian Journal of Orthopaedic Research,
Introduction: Tennis elbow occurs due to overexertion of the extremity with repetitive wrist extension and alternating forearm pronation/supination and occurs in 1 to 3% population. Surgical procedures are available like open, percutaneous and arthroscopic common extensor tendon release. Among them percutaneous release is a safe and simple surgical procedure with good-to-excellent results.
Material and Methods: A prospective observational study was conducted in 50 patients at National Medical college and Teaching Hospital, Birganj, Nepal for one year duration among age 30 to 60 years with more than 6 months duration of pain and one dose previous steroid injection. Informed consent was taken before procedure. Percutaneous release was performed using 10ml of 2% lignocaine for local anesthesia and 18G needle for tenotomy in minor operation theatre. The patients were assessed by using quick DASH score.
Results: Out of 50 patients mean age was 43.50 ± 8.187 years, 31(62%) were female and right side 31(62%) was commonly affected. Mean duration of pain was 9.98 ± 4.359 months. All of the patients had taken treatment previously. The post operative outcome was excellent 48(96%) to good in 2(4%) patients. Mean quick DASH score Preoperative was 63.84 ± 4.87 (range 45.45 to 79.45), at 6 weeks follow up was 10.67 ± 7 .68 (range from 2.27 to 34.09) and at 6 months follow up was 5.86 ± 3.34 (range0.00 to 13.63). There was significant correlation between Quick DASH score at preoperative period and at six weeks follow up (r = .309, P = 0.03) and at six months follow up (r = .555, P < 0.000). No complication was reported. All the patients returned to their normal jobs and activities.
Conclusion: The study concluded that percutaneous release of the common extensor origin for tennis elbow is effective treatment for tennis elbow with least complications.
- Tennis elbow
- percutaneous extensor tendon release
- Quick DASH score
How to Cite
Riff AJ, Saltzman BM, Cvetanovich. G, Frank JM, Hemu MR, Wysocki RW. Open vs percutaneous vs arthroscopic surgical treatment of lateral epicondylitis: an updated systematic review. Am J Orthop (Belle Mead NJ). 2018;47(6).
Wittenberg RH, Schaal S, Muhr G: Surgical treatment of persistent elbow epicondylitis. Clin Orthop Relat Res. 1992;278:73–80
Goldie I: Epicondylitis lateralis humeri (epicondylalgia or tennis elbow): A pathogenetical study. Acta Chir Scand Suppl. 1964;57(suppl 339):1+.
Haahr JP, Andersen JH: Physical and psychosocial risk factors for lateral epicondylitis: A population based case-referent study. Occup Environ Med. 2003;60:322-329
Savoie FH 3rd, O’Brien MJ. Arthroscopic tennis elbow release. Instr Course Lect. 2015;64:225-30.
Burn MB, Mitchell RJ, Liberman SR, Lintner DM, Harris JD, McCulloch PC. Open, arthroscopic, and percutaneous surgical treatment of lateral epicondylitis: a systematic review. Hand. 2018;13(3): 264-74.
Chen J, Wang A, Xu J, Zheng M. In chronic lateral epicondylitis, apoptosis and autophagic cell death occur in the extensor carpi radialis brevis tendon. J Shoulder Elbow Surg. 2010;19(3): 355-62.
Brummel J, Baker CL 3rd, Hopkins R, Baker CL Jr. Epicondylitis: lateral. Sports Med Arthrosc Rev. 2014;22(3)1-6.
Dong W, Goost H, Lin XB, et al. Injection therapies for lateral epicondylalgia: a systematic review and Bayesian network meta-analysis. Br J Sports Med. 2016;50(15):900-8.
Nirschl RP, Pettrone FA: Tennis elbow. The surgical treatment of lateral epicondylitis . J Bone Joint Surg Am. 1979;61(6A):832–9
Boyd HB, McLeod AC Jr. Tennis elbow. J Bone Joint Surg Am 1973; 55(6): 1183-7
Lo MY, Safran MR: Surgical treatment of lateral epicondylitis: a systematic review. Clin Orthop Relat Res. 2007;463:98-106.
Dunkow PD, Jatti M, Muddu BN: A comparison of open and percutaneous techniques in the surgical treatment of tennis elbow. J Bone Surg (Br). 2004;86:701-4.
Yerger B, Turner T: Percutaneous extensor tenotomy for chronic tennis elbow: an office procedure. Orthopaedics. 1985;8:1261-3.
Baumgard SH, Schwartz DR: Percutaneous release of the epicondylar muscles for humeral epicondylitis. Am J Sports Med. 1982;10:233-6.
Panthi S, Khatri K, Kharel K, et al.Outcome of Percutaneous Release of Tennis Elbow: A Non-Randomized Controlled Trial Study. Cureus 2017;9(1): e952.
M.A. Nazar, S. Lipscombe, S. Morapudi, G. Tuvo, R. Kebrle, W. Marlow and M. Waseem Percutaneous Tennis Elbow Release Under Local Anaesthesia the Open Orthopaedics Journal, 2012;6: 129-132.
Verhaar J, Walenkamp G, Kester A, van Mameren H, van der Linden T. Lateral extensor release for tennis elbow. A prospective long-term follow-up study. J Bone Joint Surg Am. 1993;75(7): 1034-43.=
DOI:10.2106/00004623-199307000-00010. PMID: 8335663.
Solheim E, Hegna J, Oyen J. Extensor tendon release in tennis elbow: results and prognostic factors in 80 elbows. Knee Surg Sports Traumatol Arthrosc. 2011;19(6): 1023-7.
Phillips NJ, Ali A, Stanley D.Treatment of primary degenerative arthritis of the elbow by ulnohumeral arthroplasty. A long-term follow-up. J Bone Joint Surg Br. 2003; 85:347–350
De Smedt T, de Jong A, Van Lemur W, Lieven D, Van Gabbed F. Lateral epicondylitis in tennis: update on aetiologia, biomechanics, and treatment. Br J Sports Med. 2007;41: 816–819.
Coonrad RW, Hooper WR. Tennis elbows its course natural history conservative and surgical management. J Bone Joint Surg Am. 1973;55(6):1177–82.
Nirschl RP. Muscle and tendon trauma: Tennis elbow. In: Morrey BF, editor. The elbow and its disorders. Philadelphia: WB Saunders. 1985:481–96.
Loose R. Tennis elbow: Twenty years experience. Presented at the Hawkeye Sports Medicine Symposium Iowa City Iowa. 1984:5–7.
Seyhmus Yigit. Medium-term results after treatment of percutaneous tennis elbow release under local anaesthesia Acta Biomed. 2020;91(2):305-309.
Abstract View: 236 times
PDF Download: 82 times