Semicircumferential detachment of the extensor enthesis for surgical treatment of chronic lateral epicondylitis: A prospective study

About 10% of patients with lateral epicondylitis are nonresponsive to conservative treatment; as controversy persists on etiology and pathogenesis of this pathology, there is no surgical technique universally approved. The purpose of this study is to describe and evaluate the clinical outcomes of our technique consisting in a semicircumferential and partial detachment of the entire extensor apparatus enthesis. The technique was performed on 14 consecutive patients affected by painful chronic epicondylitis between January 2010 and April 2016. Two patients were lost during follow-up. At 6 months, 1 year, and 2 years after surgery patients were revaluated. Outcomes were assessed using Visual Analog Scale, DASH score Disability of the Arm, Shoulder, and Hand, Jamar test, and time to return to work. The mean surgical time was 16 minutes. The postoperative outcomes were excellent in most patients as mean Visual Analog Scale score improved from 9.25 to 2.6 and mean DASH score improved from 82.9 to 29.6. No recurrence was recorded at 2 years of follow-up. The procedure is rapid to perform, reproducible and provides low complication rates and no relapse in our experience. As a result, we recommend this technique in nonresponding to conservative treatment lateral epicondylitis.