Adigüzel Ibrahim Faruk, Bayrak Hünkar Cagdas, Orman Osman, Ordu Samed
Ankara Etlik City Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Eskisehir Yunus Emre State Hospital, Department of Orthopaedics and Traumatology, Eskisehir, Turkey.
Acta Chir Orthop Traumatol Cech. 2025 Jun;92(2):98-105. doi: 10.55095/achot2024/060.
This retrospective comparative study aims to evaluate the clinical outcomes, cost-effectiveness, and complication rates associated with two minimally invasive surgical techniques: extended arthroscopic debridement and 18-gauge percutaneous tenotomy.
The study included 31 patients with resistant lateral epicondylitis who underwent either arthroscopic debridement (n=14) or percutaneous tenotomy (n=17) between January 2019 and June 2023. Outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and the Patient-Rated Tennis Elbow Evaluation (PRTEE) at preoperative, 3-month, 6-month, and 12-month intervals. Additionally, a detailed cost analysis was performed to compare the economic implications of both surgical techniques.
The results demonstrated significant improvements in both groups at 3 and 6 months postoperatively. However, by the 12-month follow-up, the arthroscopic group maintained stable clinical outcomes, while the percutaneous group showed a decline in MEPS and PRTEE scores, suggesting a potential regression in long-term efficacy. Despite this, the percutaneous tenotomy group benefited from a shorter procedure time, fewer complications, and a quicker return to work, making it a highly cost-effective alternative.
In conclusion, while extended arthroscopic debridement offers sustained clinical benefits, particularly in long-term follow-up, 18-gauge percutaneous tenotomy emerges as a viable primary intervention due to its simplicity, low complication rate, and significant cost savings. Future studies with larger cohorts and longer follow-up periods are warranted to further elucidate the long-term effectiveness and patient satisfaction associated with these techniques.
本回顾性比较研究旨在评估两种微创手术技术（扩大关节镜清创术和18号经皮肌腱切断术）的临床疗效、成本效益和并发症发生率。
该研究纳入了31例难治性外侧肱骨髁炎患者，他们在2019年1月至2023年6月期间接受了关节镜清创术（n = 14）或经皮肌腱切断术（n = 17）。在术前、术后3个月、6个月和12个月时，使用梅奥肘关节功能评分（MEPS）和患者自评网球肘评估（PRTEE）对结果进行评估。此外，还进行了详细的成本分析，以比较两种手术技术的经济影响。
结果显示，两组在术后3个月和6个月时均有显著改善。然而，在12个月的随访中，关节镜组的临床疗效保持稳定，而经皮组的MEPS和PRTEE评分有所下降，提示长期疗效可能出现衰退。尽管如此，经皮肌腱切断术组手术时间较短，并发症较少，恢复工作较快，是一种极具成本效益的选择。
总之，虽然扩大关节镜清创术具有持续的临床益处，尤其是在长期随访中，但18号经皮肌腱切断术因其操作简单、并发症发生率低和显著节省成本，成为一种可行的初始干预方法。有必要开展更大样本量和更长随访期的未来研究，以进一步阐明这些技术的长期有效性和患者满意度。
