Arthroscopic Release of the Pronator-Flexor Origin for Medial Epicondylitis

We performed arthroscopic surgery for medial epicondylitis and evaluated pain relief, self-assessed functional outcome, and complications after the procedure. The patients included 2 males and 2 females with a mean age of 48.3 years. The average length of follow-up was 16.2 months. The pronator-flexor origin was partially released from the medial epicondyle in all elbows. In 2 cases, débridement of calcinosis in the pronator-flexor origin was also performed. In 2 of the 5 elbows, active flexion was preoperatively limited to 100 degrees, but the range of flexion recovered to the same as that on the contralateral side by the final follow-up. Postoperative valgus instability was not observed. The average scores using a visual analog scale for pain at rest and during activity improved from 5.8±4.4 to 0.3±0.6 and from 8.3±1.9 to 2.3±2.2, respectively. The mean DASH score improved from 59.1±24.3 to 7.5±10.3. According to Nirschl and Pettrone grading system, the outcomes were excellent for 3 elbows and good for 2 elbows. Medial antebrachial cutaneous nerve irritation occurred in 1 elbow, but finally resolved. Arthroscopic partial release and débridement of the common pronator-flexor origin is effective and safe procedure for recalcitrant medial epicondylitis.

Source: Techniques in Shoulder and Elbow Surgery - May 2, 2018 Category: Orthopaedics Tags: Techniques Source Type: research