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Treatment of Recalcitrant Lateral Epicondylitis With Suture Anchor Repair
Ist Teil von
The American journal of sports medicine, 2005-10, Vol.33 (10), p.1558-1564
Ort / Verlag
Los Angeles, CA: American Orthopaedic Society for Sports Medicine
Erscheinungsjahr
2005
Quelle
MEDLINE
Beschreibungen/Notizen
Background: Chronic lateral epicondylitis has been treated with various surgical procedures with varying and often less-than-satisfactory
outcomes.
Hypothesis: 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.
Study Design: 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, 2.2â9.5 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, 4.0â10.0), whereas the
mean postoperative pain score was 0.41 (range, 0â1.5), 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.
Conclusion: 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.
Keywords:
lateral epicondylitis
suture anchor
recalcitrant
Disabilities of the Arm, Shoulder, and Hand (DASH)