Surgical treatment of recalcitrant lateral epicondylitis using a minimal incision technique

Abstract

BACKGROUND: Lateral epicondylitis responds well to conservative methods of treatment such as drugs, braces and local infiltration of steroids, autologous blood, and platelet-rich plasma. The patients who do not respond to conservative methods become candidates for surgical intervention. In our study, we have performed the Nirschl procedure through a smaller incision. MATERIALS AND METHODS: Our study included 18 patients having lateral epicondylitis treated with an open debridement of extensor carpi radialis brevis using a small incision. In our study, we had six males and 12 females, with 14 patients having involvement on the right side and four patients on the left side. Patients were followed up for a mean period of 28.8 months, and the final outcome was assessed using the QuickDASH score, visual analog scale (VAS), and the Nirschl and Pettrone's grading system. RESULTS: According to the QuickDASH scoring scale, the preoperative mean score improved from 74.4 to 49.7 postoperatively, which is statically significant (P < 0.05). According to the Nirschl and Pettrone's grading system, 14 (77.7%) cases were excellent, 3 (16.7%) were good, and 1 (5.6%) was fair and none had a failure. The mean VAS score for pain at rest improved from 4.7 (range from 3 to 6) preoperatively to 0.7 (range from 0 to 2) at the last follow-up (P < 0.05)). The mean VAS score during daily activities improved from 6.9 (range from 4 to 8) preoperatively to 1.2 (range from 0 to 2) at the last follow-up (P < 0.05). CONCLUSION: Surgical intervention via the Nirschl operative technique is ideal for recalcitrant lateral epicondylitis.