| Peer-Reviewed

Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study

Published: 2 April 2013
Views:       Downloads:
Abstract

“Tennis Elbow” or Lateral Epicondylitis is a painful syndrome of the elbow which affects a large portion of the adult population, such as heavy labour workers and athletes. The aim of this comparative study is the investigation of the results of the percutaneous technique as a surgical treatment method compared to the conservative treatment for people suffering from this syndrome. Fourty-six patients with 52 suffering elbows constituted the group that was treated surgically and 51 patients with 59 suffering elbows constituted the group that was treated conservatively. The Verhaar et al. scoring system was used for the evaluation of the treatment results both preoperatively or before the beginning of the conservative treatment and 15 days and one, two, four and six months postoperatively. The Verhaar et al. scoring system was also used for the evaluation of the pain, the local sensitivity, the hand grip with the use of a dynamometer and the elbow’s and forearm’s range of motion (ROM) with the use of a goniometer. It has been demonstrated that the percutaneous technique is superior to the conservative treatment because it provides better results. In addition, the patients who were treated with the percutaneous technique developed a greater range of motion (ROM) in the elbow extension, the supination and mainly in the pronation of the forearm in the reevaluations compared to the conservatively treated group. In conclusion, the percutaneous release of the extensor tendons in the elbow, in cases of the “Tennis Elbow” syndrome, provides very good results. At the same time it is an easier and safer procedure compared to other surgical techniques.

Published in Journal of Surgery (Volume 1, Issue 1)
DOI 10.11648/j.js.20130101.12
Page(s) 6-11
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Tennis Elbow, Epicondylitis, Percutaneous Technique, Conservative Treatment

References
[1] Runge F. Zur genese und behandlung des schreibe kranfes, Bed Klin Worchenschr, Vol. 10, pp. 245–248, 1873.
[2] Morris H. The rider’s sprain, Lancet, Vol. 2, pp. 133–134, 1882.
[3] J. Verhaar, G. Walenkamp, A. Kester, H. van Mameren and T. van der Linden, "Lateral extensor release for tennis elbow. A prospective long-term follow-up study," J Bone Joint Surg Am, Vol. 75, No. 7, pp. 1034-1043, 1993.
[4] L. Bisset, N Smidt, D. A. Van der Windt, L. M. Bouter, G. Jull, P. Brooks and B. Vicenzino, "Conservative treatments for tennis elbow-do subgroups of patients respond different-ly?," Rheumatology, Vol. 46, pp. 1601-1605, 2007.
[5] T. Noteboom, R. Cruver, J. Keller, B. Kellogg and A. J. Nitz, "Tennis Elbow: A Review," Journal of Orthopaedic and Sports Physical Therapy, Vol. 19, No. 6, pp. 357-366, 1994.
[6] P. Kivi, "The etiology and conservative treatment of humeral epicondylitis," Scand J Rehabil Med, Vol. 15, pp. 37-41, 1983.
[7] R. P. Nirschl and F. A. Pettrone, "Tennis Elbow. The surgical treatment of lateral epicondylitis," J Bone Joint Surg Am, Vol. 61, No. 6A, pp. 832-839, 1979.
[8] P. D. Dunkow, M. Jatti and B. N. Muddu, "A comparison of open and percuntaneous techniques in the surgical treatment of tennis elbow," J Bone Joint Surg Br, Vol. 86, No. 5, pp. 701-704, 2004.
[9] J. O’ Neil, K. Sarkar and H. K. Uhthoff, "A retrospective study of study of surgically treated cases of tennis elbow," Acta Orthop Belg, Vol. 46, No. 2, pp. 189-196, 1980.
[10] A. M. Othman, "Arhtroscopic versus percutaneous release of common extensor origin for treatment of chronic tennis elbow," Arch Orthop Trauma Surg, Vol. 131, No. 3, pp. 383-388, 2011.
[11] J. H. Cyriax, "The pathology and treatment of tennis elbow", J Bone Joint Surg Am, Vol. 18, No. 4, pp. 921-940, 1936.
[12] A. M. Strasak, Q. Zaman, K. P. Pfeiffer, G. Göbel and H. Ulmer, "Statistical errors in medical research-a review of common pitfalls", Swiss Med WKLY, Vol. 137, pp. 44-49, 2007.
[13] J. B. du Prel, B. Röhrig, G. Hommel and M. Blettner, "Choosing statistical tests", Dtsch Arztebl Int, Vol. 107, No. 19, pp. 343-348, 2010.
[14] G. Brattberg, "Acupuncture therapy for tennis elbow", Pain, Vol. 16, pp. 285-288, 1983.
[15] E. Haker and T. Lundeberg, "Acupuncture treatment in epicondylalgia: A comparative study of two acupuncture techniques", The Clinical Journal of Pain, Vol. 6, pp. 221-226, 1990.
[16] A. M. Othman, "Arthroscopic versus percutaneous release of common extensor origin for treatment of chronic tennis elbow", Arch Orthop Trauma Surg, Vol. 131, No. 3, pp. 383-388, 2011.
[17] Y. A. Radwan, G. ElSobhi, W. S. Badawy, A. Reda, S. Kha-lid, "Resistant tennis elbow: shock-wave therapy versus percutaneous tenotomy", Int Orthop, Vol. 32, No. 5, pp. 671-677, 2008.
[18] M. A. Nazar, S. Lipscombe, S. Marapudi, G. Tuvo, R. Keb-rle, W. Marlow and M. Waseem, "Percutaneous tennis elbow release under local anaesthesia", The Open Orthopaedics Journal, Vol. 6, pp. 129-132, 2012.
[19] J. Pomerance, "Radiographic analysis of lateral epicondylitis", J Shoulder Elbow Surg, Vol. 11, No. 2, pp. 156-157, 2002.
[20] R. P. Nirschl, "Lateral and medial epicondylitis", In: B.F. Morrey, editor. Master techniques in orthopaedic surgery: the elbow. New York: Raven Press, pp. 537-552, 1994.
[21] M. G. Ciccotti, "Epicondylitis in the athletess", Instr Course Lect, Vol. 48, pp. 375-381, 1999.
Cite This Article
  • APA Style

    Balalis Konstantine, Topalidou Anastasia, Silignakis Panagiotis, Ziogas Kleanthis, Balali Catherine. (2013). Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study. Journal of Surgery, 1(1), 6-11. https://doi.org/10.11648/j.js.20130101.12

    Copy | Download

    ACS Style

    Balalis Konstantine; Topalidou Anastasia; Silignakis Panagiotis; Ziogas Kleanthis; Balali Catherine. Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study. J. Surg. 2013, 1(1), 6-11. doi: 10.11648/j.js.20130101.12

    Copy | Download

    AMA Style

    Balalis Konstantine, Topalidou Anastasia, Silignakis Panagiotis, Ziogas Kleanthis, Balali Catherine. Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study. J Surg. 2013;1(1):6-11. doi: 10.11648/j.js.20130101.12

    Copy | Download

  • @article{10.11648/j.js.20130101.12,
      author = {Balalis Konstantine and Topalidou Anastasia and Silignakis Panagiotis and Ziogas Kleanthis and Balali Catherine},
      title = {Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study},
      journal = {Journal of Surgery},
      volume = {1},
      number = {1},
      pages = {6-11},
      doi = {10.11648/j.js.20130101.12},
      url = {https://doi.org/10.11648/j.js.20130101.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20130101.12},
      abstract = {“Tennis Elbow” or Lateral Epicondylitis is a painful syndrome of the elbow which affects a large portion of the adult population, such as heavy labour workers and athletes. The aim of this comparative study is the investigation of the results of the percutaneous technique as a surgical treatment method compared to the conservative treatment for people suffering from this syndrome. Fourty-six patients with 52 suffering elbows constituted the group that was treated surgically and 51 patients with 59 suffering elbows constituted the group that was treated conservatively. The Verhaar et al. scoring system was used for the evaluation of the treatment results both preoperatively or before the beginning of the conservative treatment and 15 days and one, two, four and six months postoperatively. The Verhaar et al. scoring system was also used for the evaluation of the pain, the local sensitivity, the hand grip with the use of a dynamometer and the elbow’s and forearm’s range of motion (ROM) with the use of a goniometer. It has been demonstrated that the percutaneous technique is superior to the conservative treatment because it provides better results. In addition, the patients who were treated with the percutaneous technique developed a greater range of motion (ROM) in the elbow extension, the supination and mainly in the pronation of the forearm in the reevaluations compared to the conservatively treated group. In conclusion, the percutaneous release of the extensor tendons in the elbow,  in cases of the “Tennis Elbow” syndrome, provides very good results. At the same time it is an easier and safer procedure compared to other surgical techniques.},
     year = {2013}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Percutaneous Surgical Technique for Persistent Tennis Elbow: A Comparative Study
    AU  - Balalis Konstantine
    AU  - Topalidou Anastasia
    AU  - Silignakis Panagiotis
    AU  - Ziogas Kleanthis
    AU  - Balali Catherine
    Y1  - 2013/04/02
    PY  - 2013
    N1  - https://doi.org/10.11648/j.js.20130101.12
    DO  - 10.11648/j.js.20130101.12
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 6
    EP  - 11
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20130101.12
    AB  - “Tennis Elbow” or Lateral Epicondylitis is a painful syndrome of the elbow which affects a large portion of the adult population, such as heavy labour workers and athletes. The aim of this comparative study is the investigation of the results of the percutaneous technique as a surgical treatment method compared to the conservative treatment for people suffering from this syndrome. Fourty-six patients with 52 suffering elbows constituted the group that was treated surgically and 51 patients with 59 suffering elbows constituted the group that was treated conservatively. The Verhaar et al. scoring system was used for the evaluation of the treatment results both preoperatively or before the beginning of the conservative treatment and 15 days and one, two, four and six months postoperatively. The Verhaar et al. scoring system was also used for the evaluation of the pain, the local sensitivity, the hand grip with the use of a dynamometer and the elbow’s and forearm’s range of motion (ROM) with the use of a goniometer. It has been demonstrated that the percutaneous technique is superior to the conservative treatment because it provides better results. In addition, the patients who were treated with the percutaneous technique developed a greater range of motion (ROM) in the elbow extension, the supination and mainly in the pronation of the forearm in the reevaluations compared to the conservatively treated group. In conclusion, the percutaneous release of the extensor tendons in the elbow,  in cases of the “Tennis Elbow” syndrome, provides very good results. At the same time it is an easier and safer procedure compared to other surgical techniques.
    VL  - 1
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • University of Crete – Faculty of Medicine, Department of Orthopaedics and raumatology, University Hospital of Heraklion, Greece

  • University of Crete – Faculty of Medicine, Department of Orthopaedics and raumatology, University Hospital of Heraklion, Greece

  • University of Crete – Faculty of Medicine, Department of Orthopaedics and raumatology, University Hospital of Heraklion, Greece

  • University of Crete – Faculty of Medicine, Department of Orthopaedics and raumatology, University Hospital of Heraklion, Greece

  • University of the Aegean, Unit of Mytilene, Greece

  • Sections