Acta Orthop Traumatol Turc. 2002;36(4):336-40.
OBJECTIVES: We evaluated the results and advantages of percutaneous extensor tenotomy performed in patients with lateral epicondylitis resistant to conservative treatment. METHODS: Percutaneous extensor tenotomy was performed in nine patients (7 females, 2 males; mean age 44 years; range 32 to 54 years) with lateral epicondylitis unresponsive to conservative treatment. The mean duration of the complaints was 25 months (range 9 months to 4 years), during which a mean of 2.7 (range 2 to 4) local corticosteroid injections was administered. The patients were operated under local anesthesia in an outpatient setting. The procedure lasted approximately 4.5 minutes. The remaining portion of the tendon was removed by manipulation. The results were evaluated according to the criteria by Verhaar et al. The mean follow-up period was nine months (range 4 to 15 months). RESULTS: The patients were able to use their affected arms after a mean of nine days (range 6 to 14 days). Hematoma that developed in the lateral epicondyle distally in two patients resolved spontaneously. All patients' complaints of pain decreased by more than 50% within six to eight weeks. The results were excellent or good in eight patients and fair in one patient. All patients but one were satisfied with the result of tenotomy. CONCLUSION: Percutaneous extensor tenotomy is a simple procedure; it can be performed under outpatient settings, and yields favorable results in patients with lateral epicondylitis resistant to conservative treatment.
J Sports Med Phys Fitness. 2002 Jun;42(2): 190-7.
BACKGROUND: To ascertain whether there were any differences in the outcome of release of the common extensor origin and release of the common extensor origin and drilling of the lateral epicondyle in the management of recalcitrant tennis elbow. METHODS: One hundred and eleven patients (125 elbows; 40 males, median age: 47 years; 71 females, median age: 45 years) entered the study. The minimum follow-up period was 2 years (average follow-up: 52.8 months). Patients were reviewed at 2 and 6 or 8 weeks, and 3 and 6 months after surgery. If a complication ensued, or if a patient did not report improvements, they were followed up for at least 1 year postoperatively. Two years after the recruitment period had ended, telephone interviews were performed. We used a 1 to 10 scale when enquiring about pain, both preoperative and postoperative, with 1 as the best score and 10 the worst. We also determined patient satisfaction, grip strength, and elbow function. RESULTS: Seventy-five percent of patients had excellent or good results, with 73% of them being satisfied with the results of surgery. There was no statistical significance in the outcome of the 2 procedures (chi-square, p=0.488). There were no statistically significant differences between the 2 procedures regarding pain, satisfaction, elbow function, and grip strength. CONCLUSIONS: Release of the common extensor origin at the elbow is a relatively simple operation, and produces reliable long term relief of tennis elbow pain in at least 70% of patients.
Am J Sports Med 1982 Jul;10(4):233-236
This paper describes 44 percutaneous epidondylar releases
performed on 34 patients with humeral epicondylitis. There were
35 instances of lateral epicondylitis and 6 of medical
epidondylitis. Thirty-two of the lateral releases had an
excellent result and 3 were unsatisfactory. Five of the medial
procedures were rated as excellent and one unsatisfactory. Two of
the three unsatisfactory lateral procedures were reoperated upon
with an excellent result. The one unsatisfactory medial
epicondylitis underwent reoperation and had excellent results. In
our experience, percutaneous release has a high rate of success,
is simple to perform, does not require hospitalization, and has
been without complication.
J Bone Joint Surg Am 1993 Jul;75(7):1034-1043 Department of Orthopaedics, University Hospital Maastricht, The Netherlands.
A prospective study was done of the results of lateral release of the common extensor origin in sixty-three patients who had a tennis elbow. Fifty-seven of these patients were followed for a mean of fifty-nine months (range, fifty to sixty-five months). At the time of the operation, the extensor origin was macroscopically normal in all but six patients. Forty-seven (76 per cent) of the sixty-two patients who were evaluated at one year had no pain or only slight pain, whereas before the operation three patients (5 per cent) had had slight pain and sixty (95 per cent), severe pain. Of the fifty-seven patients who were re-examined after five years, fifty-two (91 per cent) had no pain or only slight pain. At one year, twenty patients (32 per cent) had an excellent over-all result; twenty-three (37 per cent), a good result�
59; twelve (19 per cent), a fair result; and seven (11 per cent), a poor result. At five years, there were thirty-two excellent results (56 per cent), nineteen good results (33 per cent), four fair results (7 per cent), and two poor results (4 per cent). No association between the preoperative findings and the results of the operation was found. It was concluded that lateral extensor release, a relatively simple operation that can be performed in an outpatient setting, may be regarded at this time as the operative procedure with which other operations for tennis elbow should be compared.
Z Unfallchir Versicherungsmed 1993;86(3):138-144 Hopitaux de Paris.
The authors report about 72 cases of epicondylian tenotomy. It is a simple operative technique, which is described in details. This technique allows rapid post-operative course and good results in 97% of the cases.
Rev Prat 1991 Jun 21;41(18):1651-1655 Service de rhumatologie, Centre medico-chirurgical Foch, Suresnes.
Tennis elbow is most often due to a tendinitis of the extensor carpi radialis brevis, and occasionally of the extensor digitorum. Pain felt at the outer aspect of the elbow, is elicited by grasping. Passive movements are painless, and of full range, excepted for extension, and varus strain tested in slight flexion. Isometric contraction of all the muscles controlling the joint are painless, excepted resisted extension of the wrist. The most usual painful spots lay on the lateral epicondyle, or lower on the common tendon. Diagnosis is confirmed when signs disappear immediately after a correct injection of lignocaine, and persist at least 3 Weeks if a corticoid is added. The two outstanding differential diagnoses are internal derangement of the humero-radial joint, and entrapment of the sensory branch of the radial nerve. Many treatments are indicated. In a series of 58 cases, cervical manipulations give in most cas
es only a temporary relief; deep transverse massage applied on the tendon below the epicondyle, gives in a series of 131 cases good and excellent results in 63% of the cases. In a series of 257 cases, injections of corticoids gives full relief in all cases, but the rate of recurrences is 66.7%, although 67% of those recur only once or twice. Percutaneous tenotomy performed only in patients recurring after temporary cure, drops the rate of recurrences to 13%. The last alternative is open surgery, releasing the common tendon.
Copyright © 2021 DR. L. OMBREGT All Rights
ReservedLateral extensor release for tennis elbow. A prospective long-term follow-up study.
Verhaar J, Walenkamp G, Kester A, van Mameren H, van der Linden T
[Refractory epicondylitis: technique of simple epicondylian tenotomy, 72 cases].
[Article in French]
Daubinet G, Maillot J
[Tennis elbow].
[Article in French]
Troisier O
[Start]
[Main Elbow]
[A System of Orthopaedic Medicine]
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