Surgical treatment of epicondylitis is still a topic of discussion mainly with regard to timing and type of therapy and to long-term results. Many surgical techniques have been suggested (and used by us, too), such as: tendon scarification, possibly in association with bone drilling, epicondylar muscle detachment and sensory deafferentation. Nevertheless, these techniques show some limits: general or peripheral anaesthesia, invasive approach, post-operative immobilisation (requiring rehabilitation), and a long time for recovery (2 months in our experience) with a delay in working activities. For more than a year we have been using radiofrequency treatment: in day-surgery, with minimally invasive technique and local anaesthesia in case of failure of non-surgical and/or infiltrative treatments. Patients were selected after differential diagnosis with other diseases (fibromyalgia, polymyalgia rheumatica, and thoracic outlet syndrome). Even if our follow-up is quite short, the results of the evaluation of the 54 treated patients show: immediate disappearance of pain, fast functional recovery, return to working activities after 3 weeks, no short-term recurrence and absence of complications.
We have studied 35 patients with infected reconstructions after segmental resection for bone tumours. Two different regimes of treatment were employed both of which entailed debridement and the use of cement impregnated with antibiotic. In 25 patients gentamicin-PMMA beads were used and in ten an antibiotic-impregnated cement spacer. Better results were achieved with the second procedure in terms of cases healed, the number of operations, time of healing, time of recovery and the functional score. The use of vancomycin in the cement spacer gave better local control.