Treatment of recalcitrant lateral epicondylitis with suture anchor repair.
BACKGROUND
Chronic lateral epicondylitis has been treated with various surgical procedures with varying and often less-than-satisfactory outcomes.


OBJECTIVE
The use of suture anchor repair of the extensor carpi radialis brevis to the lateral epicondyle in the treatment of chronic lateral epicondylitis will result in a more anatomical repair, with resultant improvements in strength, pain, and return to previous sport.


METHODS
Case series; Level of evidence, 4.


METHODS
A total of 20 patients (22 elbows) were treated surgically and were observed for a minimum of 2 years. All patients had debridement of the degenerative tissue, followed by repair of the extensor carpi radialis brevis to the lateral epicondyle with a suture anchor. The average time to follow-up was 4.2 years (range, 2.2-9.5 years). All patients completed a Disabilities of the Arm, Shoulder, and Hand questionnaire to assess residual disability, and 16 patients underwent a physical examination. The objective evaluation included the assessment of range of motion, grip strength, and pinch strength. Pain was assessed preoperatively and postoperatively using a visual analog pain scale. Patients were also questioned with regard to a return to their previous level of activities.


RESULTS
The grip and pinch strengths achieved for the operative extremity were 110% and 106%, respectively, of the nonoperative limb. The 16 patients who underwent a physical examination had achieved full range of motion, with 15 (94%) returning to their previous level of activity at an average time of 4.1 months. The mean preoperative pain score was 8.1 (range, 4.0-10.0), whereas the mean postoperative pain score was 0.41 (range, 0-1.5), indicating significant pain relief (P < .001). The Disabilities of the Arm, Shoulder, and Hand scores demonstrated only mild residual disability (mean, 6.6) at follow-up.


CONCLUSIONS
The use of a suture anchor to repair the extensor carpi radialis brevis to the epicondyle after debridement was a satisfactory procedure for recalcitrant lateral epicondylitis with regard to strength, return to previous activities, and pain relief.
Thornton
Steven J
SJ
Sports Medicine and Shoulder Service, Hospital for Special Surgery, Department of Orhopaedic Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.
Rogers
Jennifer R
JR
Prickett
William D
WD
Dunn
Warren R
WR
Allen
Answorth A
AA
Hannafin
Jo A
JA
D000328:Adult; D003646:Debridement; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010147:Pain Measurement; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013537:Sutures; D013710:Tendons / Q000473:pathology / Q000601:surgery*; D013716:Tennis Elbow / Q000503:physiopathology / Q000601:surgery*