Reoperation for failed surgical treatment of refractory lateral epicondylitis.

The reliability of surgical procedures for lateral epicondylitis makes the need for reoperation uncommon. In a review of surgical procedures followed by reoperation, failures were classified according to first operations followed by symptoms similar to those experienced preoperatively (group 1) and first operations followed by a different symptom complex (group 2). In group 1 the cause of surgical failure was inadequate release or incorrect initial diagnosis, most often relating to entrapment of the posterior interosseous nerve. In group 2 the causes of failure were shown to be capsular or ligamentous insufficiency. A careful work-up directed at the above classification and surgical procedures specifically directed at the defined cause of previous failure have resulted in successful reoperation in 11 (85 %) of 73 patients.