Arthroscopic treatment of lateral epicondylitis

Abstract

Lateral epicondylitis is a common disorder in recreational athletes during their fifth and sixth decades. Insidious onset of lateral elbow pain provoked by resisted wrist extension is the typical presentation. The diagnosis is made by history and physical exam, but adjunctive tests, such as MRI, can be considered if concomitant intra-articular pathology is suspected. With a combination of physical therapy, NSAIDs, and activity modification, nonsurgical treatment is effective in up to 90 % of cases. Athletes may also benefit from equipment modifications or a technique coach. Steroid injections may be useful in short-term management; biologic injectables, such as platelet-rich plasma or whole blood, have shown promising early results but are still being investigated. Refractory cases can be treated with a percutaneous, open, or arthroscopic release with good success rates. Arthroscopic release may be advantageous in the athlete because of purported faster recovery times and the ability to address-part concomitant intra-articular disease.