Transosseous Refixation of the Common Extensor Muscle Tendons in Chronic Lateral Epicondylitis with and without Additional Reconstruction of the LUCL - A Retrospective Evaluation of 101 Patients

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.