Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls
Background: Tennis elbow (TE) is a very commonly occurring musculoskeletal system malady and, thus, one that most orthopaedic surgeons will face on a regular basis. While traditionally considered to be a minor problem that resolves over time without treatment, scientific studies show that many patie...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-09-01
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| Series: | Journal of Orthopaedic Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773157X23000279 |
| _version_ | 1827802986082992128 |
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| author | Eirik Solheim Caryl Gay Janne Hegna Eivind Inderhaug |
| author_facet | Eirik Solheim Caryl Gay Janne Hegna Eivind Inderhaug |
| author_sort | Eirik Solheim |
| collection | DOAJ |
| description | Background: Tennis elbow (TE) is a very commonly occurring musculoskeletal system malady and, thus, one that most orthopaedic surgeons will face on a regular basis. While traditionally considered to be a minor problem that resolves over time without treatment, scientific studies show that many patients have lasting problems that affect their ability to work. This is especially troublesome for blue-collar workers depending on the nature of their work. Methods: Most cases of mild TE can be successfully treated by initial rest followed by a structured, gradually progressing rehabilitation program supervised by an experienced physiotherapist. When this fails, surgery may be indicated. For orthopaedic surgeons proficient in elbow surgery, we recommend an arthroscopic approach. For this technical review, we have drawn upon our clinical experience (and our own intra-operative pictures) as well as a review on recent literature on TE. Technique: The goal of TE surgery, irrespective of an arthroscopic or open approach, is to re-establish a healthy common extensor tendon (CET) insertion. The extensor carpi radialis brevis (ECRB) is of particular importance, it seems. In this presentation, we aim to describe in detail how TE can be treated arthroscopically by a tenotomy of the ECRB or by debridement only. Conclusion: This technical review is based on our own experience and aims to provide a thorough description of the surgical steps of arthroscopic treatment of tennis elbow and to highlight some surgical pearls and potential pitfalls. Proficiency in elbow arthroscopy is a prerequisite. For an orthopaedic surgeon already familiar with arthroscopy of this joint, the techniques presented should be easily incorporated into his or her surgical armamentarium. We present two techniques, tenotomy of the ECRB or just debridement of the ECRB. The techniques yield similar outcomes, but the latter has somewhat shorter rehabilitation. |
| first_indexed | 2024-03-11T20:48:53Z |
| format | Article |
| id | doaj.art-e859bebad98649dd811762c146165ff6 |
| institution | Directory Open Access Journal |
| issn | 2773-157X |
| language | English |
| last_indexed | 2024-03-11T20:48:53Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Reports |
| spelling | doaj.art-e859bebad98649dd811762c146165ff62023-10-01T06:03:45ZengElsevierJournal of Orthopaedic Reports2773-157X2023-09-0123100155Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfallsEirik Solheim0Caryl Gay1Janne Hegna2Eivind Inderhaug3University of Bergen, Bergen, Norway; Haraldsplass Diaconal University Hospital, Bergen, Norway; Aleris Hospital Nesttun, Bergen, Norway; Corresponding author. Department of Clinical Medicine, University of Bergen, Bergen, Norway.Lovisenberg Diaconal Hospital, Oslo, NorwayAleris Hospital Nesttun, Bergen, NorwayUniversity of Bergen, Bergen, NorwayBackground: Tennis elbow (TE) is a very commonly occurring musculoskeletal system malady and, thus, one that most orthopaedic surgeons will face on a regular basis. While traditionally considered to be a minor problem that resolves over time without treatment, scientific studies show that many patients have lasting problems that affect their ability to work. This is especially troublesome for blue-collar workers depending on the nature of their work. Methods: Most cases of mild TE can be successfully treated by initial rest followed by a structured, gradually progressing rehabilitation program supervised by an experienced physiotherapist. When this fails, surgery may be indicated. For orthopaedic surgeons proficient in elbow surgery, we recommend an arthroscopic approach. For this technical review, we have drawn upon our clinical experience (and our own intra-operative pictures) as well as a review on recent literature on TE. Technique: The goal of TE surgery, irrespective of an arthroscopic or open approach, is to re-establish a healthy common extensor tendon (CET) insertion. The extensor carpi radialis brevis (ECRB) is of particular importance, it seems. In this presentation, we aim to describe in detail how TE can be treated arthroscopically by a tenotomy of the ECRB or by debridement only. Conclusion: This technical review is based on our own experience and aims to provide a thorough description of the surgical steps of arthroscopic treatment of tennis elbow and to highlight some surgical pearls and potential pitfalls. Proficiency in elbow arthroscopy is a prerequisite. For an orthopaedic surgeon already familiar with arthroscopy of this joint, the techniques presented should be easily incorporated into his or her surgical armamentarium. We present two techniques, tenotomy of the ECRB or just debridement of the ECRB. The techniques yield similar outcomes, but the latter has somewhat shorter rehabilitation.http://www.sciencedirect.com/science/article/pii/S2773157X23000279 |
| spellingShingle | Eirik Solheim Caryl Gay Janne Hegna Eivind Inderhaug Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls Journal of Orthopaedic Reports |
| title | Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls |
| title_full | Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls |
| title_fullStr | Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls |
| title_full_unstemmed | Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls |
| title_short | Arthroscopic treatment of tennis elbow: Techniques, pearls, and pitfalls |
| title_sort | arthroscopic treatment of tennis elbow techniques pearls and pitfalls |
| url | http://www.sciencedirect.com/science/article/pii/S2773157X23000279 |
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