The results of extensor release with cortical drilling for lateral epicondylitis resistant to conservative treatment

Abstract

Objectives: We evaluated the results of open lateral extensor release with cortical drilling in patients with lateral epicondylitis resistant to conservative treatment.
Patients and methods: The study included 17 elbows of 16 patients (14 females, 2 males; mean age 43 years; range 30 to 55 years) who underwent surgical treatment with open release following unsuccessful conservative treatment for at least 12 months. The mean duration of complaints prior to surgery was 13 months (range 12 to 16 months). Surgery included extensor tenotomy distal to the lateral epicondyle with two or three holes drilled through the cortex of the lateral epicondyle. No postoperative immobilization was used. The results were assessed by comparison of preoperative and postoperative severity of pain and according to the modified functional criteria of Verhaar et al. The mean follow-up period was 26 months (range 13 to 54 months).
Results: The mean severity score of pain decreased significantly from 88.5 preoperatively to 14.2 postoperatively (p<0.05). At least 50% of pain relief was obtained after a mean of nine weeks (range 6 to 20 weeks) postoperatively. Functional results were excellent in 12 patients (75%), good in two patients (12.5%), and poor in two patients in whom coexistent radial tunnel syndrome could not be recognized. The only postoperative complication was seroma seen in one patient.
Conclusion: Our results show that formal open extensor release and cortical drilling is an effective method in the surgical treatment of lateral epicondylitis, with a high success rate and low morbidity.