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Journal of the Korean Society for Surgery of the Hand 2005;10(3):156-161.
Published online September 1, 2005.
Arthroscopic Treatment of Refractory Lateral Epicondylitis and Associated Synovitis -Preliminary Report-
Inhyeok Rhyou, Chaeik Chung, Bo Gun Suh, Byoung Won Ko, Hyun Kyoo Park
난치성 외 상과염 및 동반 활액막염의 관절내시경적 치료 - 예비보고 -
류인혁, 정재익, 서보건, 고병원, 박현규
Abstract
Purpose
To evaluate the surgical results of the arthroscopic ECRB release and associated lesions and define the indication of arthroscopic ECRB release Materials and methods: During the past 1 and 1/2 year, 13 patients with persist pain in spite of conservative treatment for at least 3 months had arthroscopic ECRB release. Follow up is at least 6 months. Patients were evaluated retrospectively. Tenderness in radiohumeral joint, axial compression test of radial head on capitellum, locking and associated radial tunnel syndrome were evaluated preoperatively. Intraoperative findings of synovitis or chondral lesions were also evaluated. Range of motion change, posterolateral rotatory instability, residual nerve symptoms, return to job and pain relief by subjective visual analogue scale (VAS)- no pain 0, and severe pain 100 were evaluated postoperatively. Results: Preoperatively tenderness in radiohumeral joins was seen in 6 cases and axial compression test of radial head on capitellum, 3 cases. Radial tunnel syndrome evaluation by EMG/NCV was done in 3 cases but not found. Locking history was not. The time interval to operation is 12.3 months. Resting pain disappeared in 10 patients within 3 months and relieved in 3 cses. 10 patients returned to their job except two work compensation related patients and one patient with degenerative arthritis. VAS was 15. There was not ROM change and not instability postoperatively. We found synovitis in 2 patients who had failed open surgery but felt comfortable after arthroscopic ECRB release and partial synovectomy. Synovitis was observed in 5 cases, mainly in patients with degenerative arthritis or hard working patients Conclusion: Arthroscopic treatment of the refractory lateral epicondylitis may be effective method because intra-articular pathology can also be treated. Now we consider arthroscopic ECRB release as primary treatment for the refractory lateral epicondylitis with high risk of intra-articular lesions.
 


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