Salvage Surgery for Lateral Tennis Elbow

We undertook a retrospective analysis of 34 patients (35 elbows) who had prior failed surgical intervention for lateral tennis elbow. Revision surgeries were per formed between 1979 and 1994. Each patient's non operative and operative history was recorded before our salvage revision surgery. At...

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Bibliographic Details
Published in:American journal of sports medicine 1997-11, Vol.25 (6), p.746-750
Main Authors: Organ, Scott W., Nirschl, Robert P., Kraushaar, Barry S., Guidi, Eric J.
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty - methods
Biological and medical sciences
Cicatrix - surgery
Debridement
Female
Humans
Male
Medical sciences
Methods
Middle Aged
Orthopedic surgery
Reoperation
Retrospective Studies
Salvage Therapy - methods
Sports injuries
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tendons - surgery
Tennis elbow
Tennis Elbow - rehabilitation
Tennis Elbow - surgery
Treatment Outcome
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Summary:We undertook a retrospective analysis of 34 patients (35 elbows) who had prior failed surgical intervention for lateral tennis elbow. Revision surgeries were per formed between 1979 and 1994. Each patient's non operative and operative history was recorded before our salvage revision surgery. At revision surgery, find ings included residual tendinosis of the extensor carpi radialis brevis tendon in 34 of 35 elbows. In 27 elbows, the pathologic changes in the extensor carpi radialis brevis tendon had not been previously addressed at all, and in 7 elbows the damaged tissue had not been completely excised. Salvage surgery included excision of pathologic tissue in the extensor carpi radialis brevis tendon origin combined with excision of excessive scar tissue and repair of the extensor aponeurosis when necessary. Based on a 40-point functional rating scale proposed here, 83% of the elbows (29 of 35) had good or excellent results at an average followup of 64 months (range, 17 months to 17 years). To prevent failure of surgical treatment for tennis elbow, the patho logic tissue usually present in the extensor carpi radi alis brevis tendon should be resected. Release oper ations, which weaken the extensor aponeurosis but fail to address the pathoanatomic changes, are not recommended.
ISSN:0363-5465
1552-3365
DOI:10.1177/036354659702500604