Functional outcomes after arthroscopic treatment of lateral epicondylitis |
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Authors: | Takuro Wada Tamami Moriya Kosuke Iba Yasuhiro Ozasa Tomoko Sonoda Mitsuhiro Aoki Toshihiko Yamashita |
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Institution: | (1) Department of Orthopaedic Surgery, Sapporo Medical University, South 1, West 16, Sapporo 060-8543, Japan;(2) Department of Public Health, Sapporo Medical University, Sapporo, Japan |
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Abstract: | Background The purpose of this study was to evaluate surgical outcomes of arthroscopic débridement for lateral epicondylitis using a
validated, patient-assessed scoring system as well as conventional outcome measures. We also wanted to identify potential
predictive factors that may be associated with the outcomes.
Methods A total of 20 elbows in 18 patients with chronic lateral epicondylitis who underwent arthroscopic surgery were included. There
were nine men and nine women with a mean age of 54 years (range 42–71 years). Operative treatment consisted of débridement
of the extensor carpi radialis brevis (ECRB) origin and resection of the radiocapitellar synovial plica interposed in the
joint. Outcomes were assessed using a patient rating, visual analogue scale (VAS) pain score, the Japanese Orthopaedic Association
(JOA) elbow score, and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. The average length of follow-up
was 28 months (range 24–40 months).
Results After surgery, according to the patients’ reports, 14 of 20 elbows were much better, and 6 elbows were better. A mean preoperative
VAS pain score at rest of 3.9 points improved to 0.3 points (P < 0.0001), and that during activity improved from 7.8 points to 0.9 points (P < 0.0001). The mean preoperative JOA elbow score of 29 points was improved to 90 points (P < 0.0001). The mean postoperative DASH score was 10.6 (range 0–50). Absent of T2-weighted high signal focus of the ECRB origin
on preoperative magnetic resonance imaging (MRI) (P = 0.02) and receiving public assistance (P = 0.01) were significantly associated with worse DASH scores.
Conclusions Arthroscopic release was a satisfactory procedure for chronic lateral epicondylitis. Preoperative MRI of the ECRB origin and
socioeconomic factors were significantly associated with postoperative residual symptoms evaluated with the DASH score. |
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