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ARTHROSCOPIC TREATMENT OF PATIENTS WITH LATERAL HUMERAL EPICONDYLITIS (TENNIS ELBOW)
- Authors: Salikhov M.R.1, Kuznetsov I.A.1, Zhabin G.I.1, Shulepov D.A.1, Zlobin O.V.1
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Affiliations:
- Vreden Russian Research Institute of Traumatology and Orthopedics
- Issue: Vol 23, No 4 (2017)
- Pages: 58-69
- Section: Clinical studies
- Submitted: 26.12.2017
- Accepted: 26.12.2017
- Published: 26.12.2017
- URL: https://journal.rniito.org/jour/article/view/831
- DOI: https://doi.org/10.21823/2311-2905-2017-23-4-58-69
- ID: 831
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Abstract
In the past decade the clinical and anatomical studies proved that lateral humeral epicondylitis can be successfully treated arthroscopically.
Purpose of the study is to identify the optimal method of surgical treatment for patients with lateral humeral epicondylitis.
Material and methods. The authors conducted an integral study consisting of two sections: clinical and anatomical. Anatomical section included precision preparation of extensor muscles of the forearm. Clinical section was dedicated to comparative analysis of statistically valid and matched by lesion severity groups of patients who underwent open and arthroscopic procedures. All patients were divided into three groups. Patients of Group I underwent arthroscopic release of extensor carpi radialis brevis tendon (ECRB) without decorticating of the lateral humeral epicondyle. Patients of Group II underwent arthroscopic release of ECRB in combination with decortication of the lateral humeral epicondyle. Patients in Group III underwent an open release of ECRB.
Results. Patients who underwent arthroscopic release of ECRB demonstrated less pronounced pain syndrome as compared to patients after ECRB release along with decortication of epicondyle or after open release (р<0,05). VAS pain score in Group I decreased from 7 to 1 point, in Group II — from 7 to 3 points, in Group III — from 7 to 4 points. Mean time until full recovery after the surgery was 24,2±7,8 days in Group I, 39,4±5,6 days in Group II and 60,2±15,6 days in Group III (р<0,05). Functional outcomes were assessed by Mayo Elbow Performance Score (MEPS) in 9 weeks postoperatively: Group I — improvement from 60 to 79 points, Group II — from 62 to 75 points, Group III — from 60 to 75 points.
Conclusion. Drilling or removal of periosteum of the damaged epicondyle does not provide a positive effect. Decortication also has certain disadvantages like postoperative pain intensification leading to lesser range of motion in elbow and increased bleeding of the wound. Patients after simple release of ECRB demonstrated minimal postoperative pain which allows early rehabilitation and return to daily and professional activities.Keywords
About the authors
M. R. Salikhov
Vreden Russian Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: virus-007-85@mail.ru
Marsel R. Salikhov — Cand. Sci. (Med.), Orthopaedics Surgeon, traumatology and Orthopedic Department N 15.
8, ul. Akad. Baykova, St. Petersburg, 195427
РоссияI. A. Kuznetsov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Igor A. Kuznetsov — Dr. Sci. (Med.), Professor, Head of the Department of Sports Traumatology and Rehabilitation.
8, ul. Akad. Baykova, St. Petersburg, 195427
РоссияG. I. Zhabin
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Georgy I. Zhabin — Dr. Sci. (Med.), Professor, Department of Sports Traumatology and Rehabilitation.
8, ul. Akad. Baykova, St. Petersburg, 195427
РоссияD. A. Shulepov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Dmitry A. Shulepov — Cand. Sci. (Med.), Laboratory Assistant, Department of Sports Traumatology and Rehabilitation.
8, ul. Akad. Baykova, St. Petersburg, 195427
РоссияO. V. Zlobin
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Oleg V. Zlobin — Head of the traumatology and Orthopedic Department N 15.
8, ul. Akad. Baykova, St. Petersburg, 195427 РоссияReferences
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