Arthroscopic release for lateral epicondylitis

Purpose: This study was performed to review the results of our early experi ence with recalcitrant lateral epicondylitis treated arthroscopically. Type of Study: This study is a case series consisting of consecutive patients w ith lateral epicondylitis treated arthroscopically by 1 surgeon. Methods: P atients failing a minimum of 6 months of conservative treatment underwent a rthroscopic release of the extensor carpi radialis brevis (ECRB) origin usi ng the proximal medial and proximal lateral portals. Associated intra-artic ular pathology was noted and addressed. The ECRB lesions were classified ac cording to their gross morphology and resected with a shaver. The lateral e picondyle was then decorticated with a burr. Results: Sixteen patients with recalcitrant lateral epicondylitis were treated with arthroscopic release of the ECRB origin on the lateral epicondyle. Of the 16 elbows undergoing s urgery, 5 (31.3%) were noted to have a type I lesion, characterized as fray ing of the undersurface of the ECRB. Five (31.3%) had a type II lesion note d by linear tears within the ECRB, and 6 (37.5%) had a type III lesion, con sisting of a partial or complete avulsion of the ECRB origin. Concurrent in tra-articular pathology (synovitis, osteophytes) was noted in 3 of 16 elbow s (18.8%) and was addressed arthroscopically. All patients were followed-up fur a minimum of year; however, 4 patients were lost to follow-up for this retrospective review due to military reassignment. Follow-up was obtained on 12 of 16 (75%) of patients at an average length of 24.1 months (range, 1 5 to 33 months). All patients reported improvement with the procedure. The average return to unrestricted work was 6.0 days (range, 0 to 28 days). Con clusions: Arthroscopic release effectively treats lateral epicondylitis whi le also affording visualization of the joint space to address associated in tra-articular pathology. Additionally, arthroscopic release is minimally in vasive and allows early rehabilitation and return to normal activities. elb ow.