title: Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex.
abstract: BACKGROUND
  There has been controversy regarding the pathogenesis and treatment of lateral epicondylitis. Different surgical techniques for the treatment of lateral epicondylitis prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic management including resection of the radio-capitellar capsular complex, using different validated scores.
  
  
  METHODS
  In this study, arthroscopic resection of a capsular fringe complex was done beside debridement of the undersurface of Extensor Carpi Radialis Brevis (ECRB). Thirty-one patients with recalcitrant lateral epicondylitis for a minimum of 6 months had surgery. In all patients, a collar-like band of radio-capitellar capsular complex was found to impinge on the radial head and subluxate into the radio-capitellar joint with manipulation under direct vision. Outcomes were assessed using Mayo Elbow Performance Index (MEPI), the Patient-Rated Tennis Elbow Evaluation (PRTEE), and the Disability of the Arm, Shoulder, and Hand (DASH), beside visual analog scale (VAS) for pain and satisfaction criteria.
  
  
  RESULTS
  After arthroscopic surgery, overall satisfaction was extremely positive, over the 31 patients, 93.5% of the patients are satisfied. The mean score for pain improved from 8.64 to 1.48 points. The total PRTEE improved from 55.53 to 10.39 points. The mean MEPI score was improved from 61.82 to 94.10 points. DASH score also improved from 24.46 to 4.81 points. All improvements are statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Arthroscopic release of ECRB in patients with chronic lateral epicondylitis is a reproducible method with a marked improvement in function within a short period, with special consideration for resection of radio-capitellar capsular complex.
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: AbdulRahman A
authors.initials: AA
authors.lastname: Babaqi
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Kotb
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: Hatem G
authors.initials: HG
authors.lastname: Said
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: AbdelHamid
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: Hesham A
authors.initials: HA
authors.lastname: ElKady
authors.affiliation: Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
authors.forename: Maher A
authors.initials: MA
authors.lastname: ElAssal
keywords: Elbow arthroscopy; Lateral epicondylitis; Radio-capitellar capsule complex; Tennis elbow
references.citation: Clin Orthop Relat Res. 2005 Oct;439:123-8
references.pmid: 16205150
references.citation: J Orthop Sci. 2009 Mar;14(2):167-74
references.pmid: 19337808
references.citation: Arthroscopy. 2008 Apr;24(4):483-5
references.pmid: 18375283
references.citation: J Shoulder Elbow Surg. 2010 Mar;19(2 Suppl):31-6
references.pmid: 20188266
references.citation: Arthroscopy. 2001 May;17(5):491-5
references.pmid: 11337715
references.citation: J Bone Joint Surg Am. 1955 Jun;37-A(3):527-33
references.pmid: 14381449
references.citation: Surg Gynecol Obstet. 1979 Oct;149(4):526-8
references.pmid: 483129
references.citation: Clin Sports Med. 2003 Oct;22(4):813-36
references.pmid: 14560549
references.citation: J Bone Joint Surg Am. 1993 Jul;75(7):1034-43
references.pmid: 8335663
references.citation: J Shoulder Elbow Surg. 2000 Nov-Dec;9(6):475-82
references.pmid: 11155299
references.citation: Clin Orthop Relat Res. 1970 Sep-Oct;72:248-53
references.pmid: 5459792
references.citation: J Shoulder Elbow Surg. 1999 Sep-Oct;8(5):481-91
references.pmid: 10543604
references.citation: J Bone Joint Surg Am. 1999 Feb;81(2):259-78
references.pmid: 10073590
references.citation: Surg Radiol Anat. 2002 Dec;24(5):302-7
references.pmid: 12497221