title: The result of surgical treatment of medial epicondylitis: analysis with more than a 5-year follow-up.
abstract: BACKGROUND
  Angiofibroblastic changes of a musculotendinous origin at the medial epicondyle characterize medial epicondylitis of the elbow. Although nonsurgical treatment is the primary approach for medial epicondylitis, surgical treatment should be considered when conservative therapy fails. This study reports the results of surgical treatment of medial epicondylitis monitored for more than 5 years.
  
  
  METHODS
  This study included 55 patients with 63 cases of medial epicondylitis between 2000 and 2010. The conservative treatment periods lasted for a minimum of 1 year, and steroid injections were administered more than twice before surgery. One surgeon conducted the surgical procedures. The Nirschl and Pettrone grades, visual analog scale (VAS) scores, Disabilities of the Arm, Shoulder and Hand (DASH) scores, Mayo Elbow Performance scores, and grip strengths were analyzed. Statistical analyses were performed using paired t tests.
  
  
  RESULTS
  The mean VAS score improved from 8.5 to 2.4 (P <.001). Nirschl and Pettrone grades rated 43% (27 elbows) as excellent and 51% (32 elbows) as good. The Mayo Elbow Performance scores improved from 72 to 88 (P <.001) and DASH scores from 57 to 23 (P <.001). The mean grip strength of the affected side improved from 30 to 43 lb (P <.001). The mean time required to return to work and exercise was 2.8 months and 4.8 months, respectively. One case of heterotrophic ossification, which had no functional instability afterward, was seen.
  
  
  CONCLUSIONS
  The results indicate that surgical treatment of medial epicondylitis could be an effective and safe treatment when conservative treatment fails.
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea. Electronic address: hsoohong@hanmail.net.
authors: Soo-Hong
authors: SH
authors: Han
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea.
authors: Jun-Ku
authors: JK
authors: Lee
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea.
authors: Hyeong-Jong
authors: HJ
authors: Kim
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea.
authors: Soo-Hyun
authors: SH
authors: Lee
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea.
authors: Ji-Woong
authors: JW
authors: Kim
authors: Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Gyeonggi, Republic of Korea.
authors: Tae-Seob
authors: TS
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010147:Pain Measurement; D012189:Retrospective Studies; D013716:Tennis Elbow / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome
keywords: Medial epicondylitis; common flexor origin release; decortications; elbow; multiple drilling; surgical treatment