Effectiveness of modified arthroscopic treatment of patients with epicondylitis of the humerus

Abstract

Background One of the most common reasons of patients’ visits with complaints in the area of the elbow joint is epicondylitis of the elbow joint. Surgical treatment is recommended if conservative treatment fails after 6-12 months. Arthroscopy of the elbow joint is one of the current surgical methods of minimally invasive interventions on the elbow joint. Purpose To conduct a comparative assessment of the effectiveness of treating epicondylitis of the elbow joint using modified arthroscopic and open techniques Methods A prospective cohort-controlled study was performed on 120 patients. The patients were divided into two groups: group 1 – patients operated on by the open method (control), group 2 – patients operated on by the arthroscopic method. Additionally, depending on the nosology, the patients were divided into four subgroups. Functional results were assessed using VAS, DASH, MEPS; additionally, dynamometry was performed before surgery, and 1, 3 and 12 months after surgery. Results There is a significant improvement in the function of the elbow joint one month after surgical treatment, mainly in III and IV subgroups according to the MEPS scale, p = 0.0001. According to the VAS scale, a pronounced and persistent decrease in pain in the long-term period compared with the preoperative period was revealed in patients of the arthroscopic subgroup p = 0.0001. According to the DASH questionnaire, the functional results in patients of arthroscopic group in the postoperative period significantly exceeded over the open method p < 0.001. Discussion The use of the open surgical method provides good or excellent functional outcomes of treatment in 75-85 %. However, it has a number of disadvantages, including infectious complications and the inability of the surgeon to identify and completely remove the pathological altered tissues. The arthroscopic technique allows leveling these shortcomings and obtaining up to 95‑100 % excellent functional results. Conclusion Based on the data obtained in this study, the reatment of patients with epicondylitis of the distal humerus according to the developed arthroscopic technique significantly improves the functional state of patients, which, in turn, improves their quality of life.

Keywords

• medial epicondylitis
• lateral epicondylitis
• arthroscopy
• tennis elbow
• elbow joint