Minimally Invasive Arthroscopic Treatment of Patients with Medial Epicondylitis

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Background. There  is  not  enough  research  on  the  topic  of  arthroscopic  treatment  of  medial  epicondylitis.  Topographic studies are needed to justify surgical approaches with minimal trauma to the medial collateral ligament and ulnar nerve. The aim of the study was to optimize the arthroscopic treatment of medial epicondylitis and evaluate its clinical effectiveness based on the results of the topographic and anatomical study. Materials and Methods. The material for the topographic and anatomical study was 12 «fresh» anatomical preparations of the human elbow joint, of which 6 were taken from female cadavers, and 6 — from men. The features of the structure and topography of the elbow medial collateral ligament were studied, and the safety and effectiveness of arthroscopic approaches to the elbow for the flexor carpi radialis release were determined. A prospective cohort comparative study was performed, which included 70 patients. Two comparative groups were formed. In the group I (35 patients) surgical treatment was carried out by the open method. The group II included 35 patients who underwent minimally invasive surgical treatment using arthroscopic technique. The results were evaluated by Mayo Elbow Perfomance Score (MEPS) and VAS before surgery and 1, 6, and 9 weeks after. Results. Functional results in 9 weeks: group I — 81.77 (95% CI 81.13; 82.41); group II — 92.66 (95% CI 91.61–93.70) points. The average score for VAS in the same period: group I — 34.30 (31.89–36.68) points; group II — 1.5 (0.46–2.45) points. Conclusion. The safe zone is located above the midline of the humeroulnaris joint by 2 (1.0–3.2) mm. The risk of the medial ulnar collateral ligament anterior bundle injury is minimal in this area. Treatment of patients with the medial epicondylitis according to the developed arthroscopic technique can significantly improve the patients functional state and quality of life.

作者简介

M. Salikhov

Vreden National Medical Research Center of Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: virus-007-85@mail.ru
ORCID iD: 0000-0002-5706-481X

Marsel R. Salikhov— Cand. Sci. (Med.)

St. Petersburg

俄罗斯联邦

D. Shulepov

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: shulepov@front.ru
ORCID iD: 0000-0002-6297-0710

Dmitry A. Shulepov — Cand. Sci. (Med.)

St. Petersburg

俄罗斯联邦

O. Zlobin

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: zlo-oleg@yandex.ru
ORCID iD: 0000-0003-0769-8766

Dmitry A. Shulepov — Cand. Sci. (Med.)

St. Petersburg

俄罗斯联邦

N. Dmitrieva

St. Mary Magdalene Children’s City Hospital No. 2

Email: NadegdaNik86@gmail.com
ORCID iD: 0000-0002-7495-7281

Nadezhda N. Dmitrieva

St. Petersburg

俄罗斯联邦

A Midaev

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: midaewali@gmail.com
ORCID iD: 0000-0003-1998-0400

Ali I. Midaev

 St. Petersburg

俄罗斯联邦

参考

  1. Morris H.J. Rider’s sprain. Lancet.1882;2:557.
  2. Descatha A., Leclerc A., Chastang J.F., Roquelaure y. Study Group on Repetitive Work. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med. 2003;45(9):993-1001. doi: 10.1097/01.jom.0000085888.37273.d9.
  3. McHardy A, Pollard H, Luo K. One-year followup study on golf injuries in Australian amateur golfers. Am J Sports Med. 2007;35(8):1354-1360. doi: 10.1177/0363546507300188.
  4. Nordander C., Ohlsson K., Akesson I., Arvidsson I., Balogh I., Hansson G.A. et al. Risk of musculoskeletal disorders among females and males in repetitive/constrained work. Ergonomics. 2009;52(10):1226-1239. doi: 10.1080/00140130903056071.
  5. Krischek O., Hopf C., Nafe B., Rompe J.D. Shock-wave therapy for tennis and golfer›s elbow--1 year followup. Arch Orthop Trauma Surg. 1999;119(1-2):62-66. doi: 10.1007/s004020050356.
  6. Zonno A., Manuel J., Merrell G., Ramos P., Akelman E., DaSilva M.F. Arthroscopic technique for medial epicondylitis: technique and safety analysis. Arthroscopy. 2010;26(5):610-616. doi: 10.1016/j.arthro.2009.09.017.
  7. Stahl S., Kaufman T. The efficacy of an injection of steroids for medial epicondylitis. A prospective study of sixty elbows. J Bone Joint Surg Am.1997;79(11):1648-1652. doi: 10.2106/00004623-199711000-00006.
  8. Szabo S.J., Savoie F.H. 3rd, Field L.D., Ramsey J.R., Hosemann C.D. Tendinosis of the extensor carpi radialis brevis: an evaluation of three methods of operative treatment. J Shoulder Elbow Surg. 2006;15(6):721-727. doi: 10.1016/j.jse.2006.01.017.
  9. Cho B.K., Kim y.M., Kim D.S., Choi E.S., Shon H.C., Park K.J., Lee E.M. Mini-open muscle resection procedure under local anesthesia for lateral and medial epicondylitis. Clin Orthop Surg. 2009;1(3):123-127. doi: 10.4055/cios.2009.1.3.123.
  10. Gabel G.T., Morrey B.F. Medial epicondylitis. In: Morrey B.F. (ed). The elbow and its disorders. 3rd ed. Philadelphia, PA: WB Saunders; 2000:537-542.
  11. Ciccotti M.G., Ramani M.N. Medial epicondylitis. Tech Hand Up Extrem Surg. 2003;7(4):190-196. doi: 10.1097/00130911-200312000-00010.
  12. Stahl S, Kaufman T. The efficacy of an injection of steroids for medial epicondylitis. A prospective study of sixty elbows. J Bone Joint Surg Am.1997;79(11):1648-1652. doi: 10.2106/00004623-199711000-00006.
  13. Ciccotti M.C., Schwartz M.A., Ciccotti M.G. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004;23(4):693-705, xi. doi: 10.1016/j.csm.2004.04.011.
  14. Ciccotti M.G., Ramani M.N. Medial epicondylitis. Tech Hand Up Extrem Surg. 2003;7(4):190-196. doi: 10.1097/00130911-200312000-00010.
  15. Jobe F.W., Ciccotti M.G. Lateral and Medial Epicondylitis of the Elbow. J Am Acad Orthop Surg. 1994;2(1):1-8. doi: 10.5435/00124635-199401000-00001.
  16. Grana W. Medial epicondylitis and cubital tunnel syndrome in the throwing athlete. Clin Sports Med. 2001;20(3):541-548. doi: 10.1016/s0278-5919(05)70268-4.
  17. Cho B.K., Kim y.M., Kim D.S., Choi E.S., Shon H.C., Park K.J. et al. Mini-open muscle resection procedure under local anesthesia for lateral and medial epicondylitis. Clin Orthop Surg. 2009;1(3):123-127. doi: 10.4055/cios.2009.1.3.123.
  18. do Nascimento A.T., Claudio G.K. Arthroscopic surgical treatment of medial epicondylitis. J Shoulder Elbow Surg.2017;26(12):2232-2235. doi: 10.1016/j.jse.2017.08.019.
  19. Peart RE, Strickler SS, Schweitzer KM Jr. Lateral epicondylitis: a comparative study of open and arthroscopic lateral release. Am J Orthop (Belle Mead NJ). 2004;33(11):565-567.
  20. Nascimento A.T., Claudio G.K. Arthroscopic surgical treatment of recalcitrant lateral epicondylitis – A series of 47 cases. Rev Bras Ortop. 2016;52(1):46-51. doi: 10.1016/j.rboe.2016.03.008.
  21. Owens B.D., Murphy K.P., Kuklo T.R. Arthroscopic release for lateral epicondylitis. Arthroscopy. 2001;17(6):582-587. doi: 10.1053/jars.2001.20098.
  22. Королев С.Б., Качесов А.В., Носов О.Б. и др. Способ оперативного вмешательства при эпикондилите плечевой кости. Травматология и ортопедия России.2011;(4):114-117. doi: 10.21823/2311-2905-2011-4-114-117.
  23. Cohen M.S., Romeo A.A. Open and arthroscopic management of lateral epicondylitis in the athlete. Hand Clin. 2009;25(3):331-338. doi: 10.1016/j.hcl.2009.05.003.
  24. Grewal R., MacDermid J.C., Shah P., King G.J. Functional outcome of arthroscopic extensor carpi radialis brevis tendon release in chronic lateral epicondylitis. J Hand Surg Am. 2009;34(5):849-857. doi: 10.1016/j.jhsa.2009.02.006.
  25. Amin N.H., Kumar N.S., Schickendantz M.S. Medial epicondylitis: evaluation and management.J Am Acad Orthop Surg. 2015;23(6):348-355. doi: 10.5435/JAAOS-D-14-00145.
  26. Kurvers H., Verhaar J. The results of operative treatment of medial epicondylitis. J Bone Joint Surg Am. 1995;77(9):1374-1379. doi: 10.2106/00004623-199509000-00014.
  27. Ollivierre C.O., Nirschl R.P., Pettrone F.A. Resection and repair for medial tennis elbow. A prospective analysis. Am J Sports Med. 1995;23(2):214-21. doi: 10.1177/036354659502300215.
  28. Zonno A., Manuel J., Merrell G., Ramos P., Akelman E., DaSilva M.F. Arthroscopic technique for medial epicondylitis: technique and safety analysis. Arthroscopy. 2010;26(5):610-616. doi: 10.1016/j.arthro.2009.09.017.

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