Publication:

Comparative study of functional outcomes of open versus arthroscopic surgery of lateral epicondylitis in a tertiary care hospital

Background Lateral epicondylitis, a degenerative tendinopathy due to microtears in extensor tendons caused by repeated pronation-supination is commonly managed by NSAIDS, physiotherapy, local steroid injections and braces. Although most are self limited, some recalcitrant cases lead to chronic pain and reduction in quality of life. Surgical management by open or arthroscopic means is a viable option but there is a gap of knowledge in current literature regarding superiority of one over the other.

Methods A total of 32 patients with recalcitrant lateral epicondylitis admitted from March 2019 to August 2020 were enrolled and randomized into two groups, receiving either open or arthroscopic debridement of diseased tendons of extensor carpi radialis longus, brevis and communis. Patients were assessed for pain, functional outcome and complications with a 6 month follow-up.

Results VAS score for pain and DASH score for functional outcome improved in all patients after surgery and there was no difference between the two groups. Although mean duration of surgery was significantly longer by arthroscopy, time to return to work was significantly shorter in this group (p<0.001). Difference in complication rate was not statistically significant.

Conclusions Based on this study, surgical management both open and arthroscopic are equally effective for recalcitrant lateral epicondylitis in terms of pain, functional score and patient satisfaction; arthroscopy however shows an earlier return to work. Either can be chosen depending on available skill, equipment and patient demands.