Anconeus muscle flap transfer for failed surgical treatment of recalcitrant chronic lateral epicondylitis

Background

Chronic lateral epicondylitis can be a painful and functionally limiting condition of the elbow. Non-operative and standard surgical treatment results can vary. Moreover, outcomes for patients who have failed previous surgical treatment are limited. We report our experience using the anconeus muscle flap transfer in comparison to standard surgical treatment and report our clinical results.

Methods

We performed a retrospective case series of 19 patients with chronic lateral epicondylitis and failure of previous treatments that were managed with anconeus muscle flap transfer. There were 11 males and 8 females, with a mean age of 44 years (range 19–72); 13 were on the right side and 6 on the left. The average time from diagnosis to the surgical procedure was over 1 year (1–10 years) and the average follow-up period was 3.7 years (1–14 years).

Results

The average pain preoperatively was 6.61 and decreased postoperatively to 1.89 (range 0–10) (P < 0.0001). Complete flexion, extension and rotation of the elbow were present in all patients except one with a 5° extension lag. The average muscle strength was 4.5/5 and grip strength almost equivalent to the contralateral arm. No infection or other postoperative complications were observed. Patients were evaluated using the Roles and Maudsley score and demonstrated excellent results for 14 patients, good for 4, and poor for 1. The average time for return to work was 2.8 months (1–7 months). Ninety-five percent of patients were satisfied with the flap transfer and pain improvement.

Conclusion

The anconeus muscle flap transfer is a safe and acceptable procedure providing satisfactory results for chronic lateral epicondylitis of the elbow. This procedure can be useful for treating patients with continued pain after previous standard surgical release.