LONG-TERM RESULTS OF SURGICAL TREATMENT FOR EPICONDYLITIS: 28 CASES

Abstract

Purpose: This work was not designed to re-examine the different surgical techniques and their indications, but to verify the long-term stability of outcome in patients having undergone the same surgical technique performed by the same surgeon (82% of the cases). The purpose of this work was to assess elbow function at more than ten years after surgery in a series of 28 elbows with a mean follow-up of 13 years.

Material and method: Between 1985 and 1990, 31 patients underwent elbow surgery in our unit for epicondylitis after failure of well-conducted medical treatment. No selection was made, all operated patients were included in the analysis. Twenty-five patients (28 elbows) could be re-evaluated. All patients included in the analysis responded to a phone interview and completed a questionnaire at a mean 13 years follow-up. The surgical technique was the same in all cases: systematic complete dissection of the common epicondyle muscles, with very superficial partial epicondylectomy with a chisel was needed.

Results: All patients in the series were reviewed at three and nine months after surgery then were included in this study at ten to fifteen years. At last follow-up, outcome was excellent in 21 elbows, good in five, and acceptable in two. There were no elbows with a poor outcome (based on the roles and Maudsley classification).

Discussion: For some, surgical treatment with muscular release would hinder muscle force and increase the risk of destabilised elbow (the epicondylar muscles being considered to actively stabilise the joint). The present analysis was unable to identify any signs suggestive of sequelae related to instability nor patient complaints related to decreased muscle force.

Conclusion: It would appear that the good results remain stable in the long term. The only case exhibiting a worse situation was in a patient with predictable problems due to cartilage injury. The good initial results were definitive, inciting us to propose this surgical procedure for patients who do not respond to medical treatment. This procedure allows renewed sports activities at the former level in the great majority of the cases after a simple standardised intervention.