Thornton Steven J, Rogers Jennifer R, Prickett William D, Dunn Warren R, Allen Answorth A, Hannafin Jo A
Sports Medicine and Shoulder Service, Hospital for Special Surgery, Department of Orhopaedic Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.
Am J Sports Med. 2005 Oct;33(10):1558-64. doi: 10.1177/0363546505276758.
Chronic lateral epicondylitis has been treated with various surgical procedures with varying and often less-than-satisfactory outcomes.
The use of suture anchor repair of the extensor carpi radialis brevis to the lateral epicondyle in the treatment of chronic lateral epicondylitis will result in a more anatomical repair, with resultant improvements in strength, pain, and return to previous sport.
Case series; Level of evidence, 4.
A total of 20 patients (22 elbows) were treated surgically and were observed for a minimum of 2 years. All patients had debridement of the degenerative tissue, followed by repair of the extensor carpi radialis brevis to the lateral epicondyle with a suture anchor. The average time to follow-up was 4.2 years (range, 2.2-9.5 years). All patients completed a Disabilities of the Arm, Shoulder, and Hand questionnaire to assess residual disability, and 16 patients underwent a physical examination. The objective evaluation included the assessment of range of motion, grip strength, and pinch strength. Pain was assessed preoperatively and postoperatively using a visual analog pain scale. Patients were also questioned with regard to a return to their previous level of activities.
The grip and pinch strengths achieved for the operative extremity were 110% and 106%, respectively, of the nonoperative limb. The 16 patients who underwent a physical examination had achieved full range of motion, with 15 (94%) returning to their previous level of activity at an average time of 4.1 months. The mean preoperative pain score was 8.1 (range, 4.0-10.0), whereas the mean postoperative pain score was 0.41 (range, 0-1.5), indicating significant pain relief (P < .001). The Disabilities of the Arm, Shoulder, and Hand scores demonstrated only mild residual disability (mean, 6.6) at follow-up.
The use of a suture anchor to repair the extensor carpi radialis brevis to the epicondyle after debridement was a satisfactory procedure for recalcitrant lateral epicondylitis with regard to strength, return to previous activities, and pain relief.
慢性外侧上髁炎已采用多种外科手术治疗，疗效各异，且往往不尽人意。
采用缝线锚钉将桡侧腕短伸肌修复至外侧上髁治疗慢性外侧上髁炎，将实现更符合解剖结构的修复，从而使力量、疼痛得到改善，并能恢复至之前的运动水平。
病例系列；证据等级，4级。
共20例患者（22个肘部）接受了手术治疗，并至少观察2年。所有患者均对退变组织进行了清创，随后用缝线锚钉将桡侧腕短伸肌修复至外侧上髁。平均随访时间为4.2年（范围2.2 - 9.5年）。所有患者均完成了上肢、肩部和手部功能障碍问卷以评估残留功能障碍，16例患者接受了体格检查。客观评估包括对活动范围、握力和捏力的评估。术前和术后使用视觉模拟疼痛量表评估疼痛程度。还询问了患者恢复至之前活动水平的情况。
手术侧肢体的握力和捏力分别达到非手术侧肢体的110%和106%。接受体格检查的16例患者已恢复了全部活动范围，其中15例（94%）平均在4.1个月时恢复至之前的活动水平。术前平均疼痛评分为8.1（范围4.0 - 10.0），而术后平均疼痛评分为0.41（范围0 - 1.5），表明疼痛得到了显著缓解（P < .001）。随访时上肢、肩部和手部功能障碍评分仅显示轻度残留功能障碍（平均6.6）。
对于顽固性外侧上髁炎，清创后使用缝线锚钉将桡侧腕短伸肌修复至外侧上髁，在力量恢复、恢复至之前的活动水平和缓解疼痛方面是一种令人满意的手术方法。
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