Successful Treatment for Chronic Tennis Elbow

Over the years, scientists have discovered that chronic tennis elbow (known as lateral epicondylitis) isn't really tendinitis at all. There may have been inflamed tissue in the beginning during the acute phase. But during the chronic phase, analysis of tissue samples shows fibrous scarring called tendinosis.

As a result, orthopedic surgeons are rethinking the treatment approach to this problem. In this study, the authors report the long-term results of arthroscopic surgery for 30 patients with chronic lateral epicondylitis. An earlier report of short-term results for 42 patients (including the original 30) was published by these same authors.

Patients were treated first with nonoperative care. Rest, modifying activities, and anti-inflammatory drugs were used. Bracing, injection, and physical therapy were prescribed as well. But when this did not change their symptoms, then surgery was done to debride (remove) the pathologic tissue. The specific method of debridement was described. Photos taken inside the elbow were included to show partial and complete rupture of the elbow capsule.

Patients were followed up by phone to assess their results up to 14 years later. The rated their elbows as much better, better, same, or worse. More detailed information about pain and function was also gathered and analyzed.

The results showed that patients who were doing well after the first two years were still doing well years later. This is one of the few long-term studies of the results of arthroscopic debridement for chronic tendinitis. Pain was minimal, function was good, and patients were satisfied with the results. No one needed further treatment with injections or surgery. There are other surgical techniques for this condition. Further studies are needed to compare results of all surgical methods to find the best approach.

References: Champ L. Baker Jr, MD, and Champ L. Baker III, MD. Long-Term Follow-Up of Arthroscopic Treatment of Lateral Epicondylitis. In The American Journal of Sports Medicine. February 2008. Vol. 36. No. 2. Pp. 254-260.