Percutaneous Tenotomy for Chronic Tennis Elbow: A Minimally Invasive Technique with Better Outcomes - A Case Series

Abstract

Background: Tennis elbow (lateral epicondylitis elbow) is a self-limiting disease of indeterminate pathogenesis. Conservative therapy is the treatment of choice. In chronic tennis elbow with failure of conservative therapy; surgical treatment is a method of choice. Percutaneous tenotomy of extensor origin for patients with chronic tennis elbow is a minimally invasive technique with better long-term outcomes.

Case report: Ten patients (six males, four females) presented with chronic tennis elbow, who did not respond to conservative treatment/non-surgical intervention for more than 6 months underwent percutaneous tenotomy in an outpatient setting. Two patients were lost to follow-up at 2 months' post-operative. The remaining eight patients were evaluated at a mean follow-up of 3 years and assessed using the numerical rating scale, disabilities of the arm, shoulder and hand questionnaire ,and Oxford elbow score. These scores had a statistically significant difference in baseline to 3-year follow-up values (P < 0.05). No adverse outcomes, recurrence of symptoms, and signs of lateral epicondylitis elbow were noted and none required open surgical release.

Conclusion: Percutaneous tenotomy, a minimally invasive technique is an effective and well-tolerated treatment for chronic tennis elbow and gives good pain relief and functional recovery.

Keywords: Extensor carpi radialis brevis; lateral epicondylitis; percutaneous tenotomy; tennis elbow.

Figure 1

Elbow position and skin incision marking.

Figure 2

Exposure of extensor tendon origin.

Figure 3

Tenotomy extensor tendon.

Figure 4

Numeric rating scale, disabilities of the arm, shoulder, and hand and Oxford scores pre-operative and follow-up.