gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Revision arthroscopic surgery for tennis elbow

Meeting Abstract

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  • presenting/speaker Takuro Wada - Saiseikai Otaru Hospital, Otaru, Japan
  • Akira Saito - Saiseikai Otaru Hospital, Otaru, Japan
  • Takashi Oda - Saiseikai Otaru Hospital, Otaru, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-484

doi: 10.3205/19ifssh0070, urn:nbn:de:0183-19ifssh00701

Published: February 6, 2020

© 2020 Wada et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: Literature regarding the outcomes of revision arthroscopic surgery for tennis elbow is limited. The purposes of the study were to report clinical outcomes for a cohort of patients with chronic tennis elbow who underwent revision arthroscopic release of the extensor carpi radialis brevis (ECRB) tendon.

Methods: From January 2003 to December 2017, 150 arthroscopic surgeries for chronic tennis elbow were performed by a single surgeon. Among them 5 patients had persisted elbow pain following a primary surgery and underwent revision arthroscopic surgery. Indications of primary surgery included failure of a minimum of 6 months of conservative treatment such as rest, activity modification, counterforce bracing, nonsteroidal anti-inflammatory medications, and corticosteroid injection. Operative treatment consisted of an arthroscopic inspection, debridement of the ECRB tendon origin, and resection of the radiocapitellar synovial plica if interposed in the joint. The mean age of 5 patients was 48 years; four were male and one was female. The average duration between primary and revision surgery was 11 months and the average follow-up period after revision surgery was 18 months. Outcome was evaluated on the basis of visual analogue pain score, range of motion of the elbow, grip strength, Japanese Elbow Society (JES) score, DASH score and patient satisfaction. Arthroscopic findings of the revision surgery were also evaluated. Statistical analysis was performed using a paired Student t test, with statistical significance set at p< 0.05.

Results and Conclusions: Significant improvements were seen in terms of postoperative pain (p < 0.05), active extension and flexion (p<0.05), grip strength (p<0.05), the JES score (p < 0.05), and DASH (p<0.05). All of 5 patients satisfied with the operative results. Arthroscopic findings of the revision surgery included insufficient release of the ECRB origin in three patients and persisted impingement of the posterolateral synovial plica in two patients.

Rate of revision arthroscopic surgery for tennis elbow was 3%. Incomplete release of the ECRB origin or synovial plica was considered to be a cause of persisted pain. Revision arthroscopic surgery resulted in reliable pain relief and improvement in elbow function in patients with persisted elbow pain following primary arthroscopic tennis elbow surgery.