title: Is posterior synovial plica excision necessary for refractory lateral epicondylitis of the elbow?
abstract: BACKGROUND
  Arthroscopic treatments for lateral epicondylitis including débridement of the extensor carpi radialis brevis (ECRB) origin (Baker technique) or resection of the radiocapitellar synovial plica reportedly improve symptoms. However the etiology of the disease and the role of the plica remain unclear.
  
  
  OBJECTIVE
  We asked if posterior radiocapitellar synovial plica excision made any additional improvement in pain or function after arthroscopic ECRB release.
  
  
  METHODS
  We retrospectively reviewed 38 patients who had arthroscopic treatment for refractory lateral epicondylitis between November 2003 and October 2009. Twenty patients (Group A) underwent the Baker technique and 18 patients (Group B) underwent a combination of the Baker technique and posterior synovial plica excision. The minimum followup was 36 months (mean, 46 months; range, 36-72 months) for Group A and 25 months (mean, 30 months; range, 25-36 months) for Group B. Postoperatively we obtained VAS pain and DASH scores for each group.
  
  
  RESULTS
  Two years postoperatively, we found no differences in the VAS pain score or DASH: the mean VAS pain scores were 0.3 points in Group A and 0.4 points in Group B, and the DASH scores were 5.1 points and 6.1 points respectively.
  
  
  CONCLUSIONS
  The addition of débridement of the posterior synovial fold did not appear to enhance either pain relief or function compared with the classic Baker technique without decortication.
authors.affiliation: Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianity Hospital, Pohang, Kyeongbuk, Korea. inhyeok_r@yahoo.co.kr
authors.forename: In Hyeok
authors.initials: IH
authors.lastname: Rhyou
authors.forename: Kang Wook
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D003646:Debridement; D004550:Elbow / Q000601:surgery; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013716:Tennis Elbow / Q000601:surgery*; D016896:Treatment Outcome