Die transossäre Refixation der Extensoren bei chronischer radialer Epikondylopathie mit und ohne Rekonstruktion des LUCL-Komplexes--eine retrospektive Analyse von 101 Patienten

TY - JOUR

T1 - Die transossäre Refixation der Extensoren bei chronischer radialer Epikondylopathie mit und ohne Rekonstruktion des LUCL-Komplexes--eine retrospektive Analyse von 101 Patienten

AU - Ries, Christian

AU - Franke, S

AU - Dietrich, F

AU - Jakubowitz, E

AU - Dehlinger, F

AU - Hollinger, B

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2013/6

Y1 - 2013/6

N2 - INTRODUCTION: The chronic lateral epicondylitis (EHR) as a common pathology of the elbow is often associated with posterolateral rotatory instability of the elbow (PLRI). After evaluation of intra-articular pathology by prior diagnostic arthroscopy, we aimed to build patient groups regarding the stability of the elbow joint. In patients with a stable elbow joint, open surgery with a debridement to the origin of the common extensor tendon and transosseous refixation was performed. Patients with relevant posterolateral rotatory instability, however, underwent an additional LUCL complex stabilisation using triceps tendon graft besides debridement as mentioned above. The purpose of this study was to evaluate and compare the clinical functional outcome between these groups.MATERIAL AND METHODS: 101 patients were included in our study. Arthroscopies were first performed on all patients to identify intra-articular pathological changes. In 26 patients with stable elbows, open surgery with debridement to the origin of the common extensor tendon and transosseous refixation was performed. For the other 75 patients who were found presenting a relevant posterolateral rotatory instability, a stabilisation of the LUCL in addition to the open procedure mentioned above was performed. Examinations and questionnaires were used for retrospective evaluation at follow-up.RESULTS: Both groups of patients revealed significant improvement in pain relief and elbow function. We observed no significant difference between the two methods concerning clinical and functional outcome.CONCLUSION: We recommend diagnostic arthroscopy with assessment of stability prior to the open performance to offer a more reliable evidence for surgical technique selection and therefore to achieve a better clinical outcome.

AB - INTRODUCTION: The chronic lateral epicondylitis (EHR) as a common pathology of the elbow is often associated with posterolateral rotatory instability of the elbow (PLRI). After evaluation of intra-articular pathology by prior diagnostic arthroscopy, we aimed to build patient groups regarding the stability of the elbow joint. In patients with a stable elbow joint, open surgery with a debridement to the origin of the common extensor tendon and transosseous refixation was performed. Patients with relevant posterolateral rotatory instability, however, underwent an additional LUCL complex stabilisation using triceps tendon graft besides debridement as mentioned above. The purpose of this study was to evaluate and compare the clinical functional outcome between these groups.MATERIAL AND METHODS: 101 patients were included in our study. Arthroscopies were first performed on all patients to identify intra-articular pathological changes. In 26 patients with stable elbows, open surgery with debridement to the origin of the common extensor tendon and transosseous refixation was performed. For the other 75 patients who were found presenting a relevant posterolateral rotatory instability, a stabilisation of the LUCL in addition to the open procedure mentioned above was performed. Examinations and questionnaires were used for retrospective evaluation at follow-up.RESULTS: Both groups of patients revealed significant improvement in pain relief and elbow function. We observed no significant difference between the two methods concerning clinical and functional outcome.CONCLUSION: We recommend diagnostic arthroscopy with assessment of stability prior to the open performance to offer a more reliable evidence for surgical technique selection and therefore to achieve a better clinical outcome.

KW - Adult

KW - Aged

KW - Arthroscopy/statistics & numerical data

KW - Combined Modality Therapy/statistics & numerical data

KW - Debridement/statistics & numerical data

KW - Female

KW - Germany/epidemiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Satisfaction/statistics & numerical data

KW - Prevalence

KW - Reconstructive Surgical Procedures/statistics & numerical data

KW - Recovery of Function

KW - Retrospective Studies

KW - Risk Factors

KW - Tendon Transfer/statistics & numerical data

KW - Tennis Elbow/diagnosis

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1055/s-0032-1328578

DO - 10.1055/s-0032-1328578

M3 - SCORING: Zeitschriftenaufsatz

C2 - 23696161

VL - 151

SP - 296

EP - 301

JO - Z ORTHOP UNFALLCHIR

JF - Z ORTHOP UNFALLCHIR

SN - 1864-6697

IS - 3

ER -