Arthroscopic ligament débridement combined with tendon repair benefits lateral collateral ligament lesions in recalcitrant lateral epicondylitis patients: a retrospective comparative study.

BACKGROUND

Untreated lateral collateral ligament (LCL) lesions in recalcitrant lateral epicondylitis (RLE) may cause residual pain and progressed to elbow instability. However, there is not enough research on the effect of arthroscopic treatment of combined LCL degenerative lesions without instability in RLE patients. The purpose of this study was to 1) evaluate the clinical and radiological results of RLE patients with LCL degenerative lesions without instability who received arthroscopic LCL débridement and extensor carpi radialis brevis (ECRB) repair, and 2) compare clinical outcomes between RLE patients with LCL degenerative lesion and those without, which received ECRB repair alone.

METHODS

A retrospective study was performed in which 31 RLE patients with LCL degenerative lesions without instability, who underwent arthroscopic LCL débridement with shaver and radiofrequency combined with ECRB repair with suture anchor arthroscopically between September 2014 and September 2022, comprised the LCL group. The control group (N = 31) was matched 1:1 for age ( ±5 years), sex, involved side, hand dominance, body mass index, working status, duration of symptoms, steroid/platelet-rich plasma injections and follow-up time. Thirty-one matched RLE patients without LCL lesions, who underwent arthroscopic ECRB repair with suture anchor alone. The visual analog scale, the Patient-Rated Tennis Elbow Evaluation, the Mayo Elbow Performance Score, and the Disability of the Arm, Shoulder, and Hand questionnaire were evaluated and compared between 2 groups at preoperative and follow-up periods (at 3, 6, and 12 months follow-up). The time duration of back to work was also compared between 2 groups. Magnetic resonance imaging (MRI) in LCL group was collected.

RESULTS

There were no significant differences in any clinical outcome at each follow-up time between the 2 groups (P > .05 for all). There were no significant differences in time duration of return to work between LCL group and control group (9.4 ± 3.0 weeks vs. 8.9 ± 3.4 weeks; P = .529). There were 26 patients showed abnormal MRI signal of LCL in LCL group preoperatively. At 12 months follow-up, none of them showed abnormal MRI signal. Additionally, there was no complication found in LCL group at the 12 months follow-up.

CONCLUSION

In patients with RLE and degeneration of an intact LCL without instability, débridement of the LCL lesion while repairing the ERCB does not seem to impair outcomes in short-term follow-up when compared to patients with RLE treated by repair of the ERCB with intact LCLs.