Table 2.
Results of surgical debridement with and without repair for chronic medial epicondylitis
| Author | Patients (n) | Procedure | Follow-up (mths) | Results | Commentary |
|---|---|---|---|---|---|
| Vangsness and Jobe (1991)22 | 35 | Debridement. | 85 | Excellent results in 25, good in nine and far in 1.86% had no limitation. | Subjective elbow function increased from 38% to 98%. Isokinetic strength showed no difference with the unoperated elbow. |
| Gabel and Morrey (1995)19 | 30 (26 patients) | Debridement of the origin of the flexor-pronator tendon mass, with decompression or transposition of the ulnar nerve. | 7 yrs (2 to 15) | 87% rate (26 elbows) of good or excellent results. | Patients without or mild ulnar neuropathy had a better outcome. Improvement was slow (> 6 mths) in 9 patients. |
| Kurvers and Verhaar (1995)20 | 40 (38 patients) | Debridement of the origin of the flexor-pronator tendon mass, with decompression of the ulnar nerve (24 patients). | 44 (24 to 67) | 25 had good subjective outcome. | Outcome was less favorable for the elbows that had had coexistent ulnar neuritis. Symptoms of ulnar neuritis persisted in 15 patients. |
| Ollivierre et al (1995)8 | 50 | Debridement and side to side repair. | 37 | No pain at rest post-operatively. 10 patients did not return to pre-operative. Activities. |
Dynamometer testing improved in all patients. |
| Vinod and Ross (2015)12 | 60 | Debridement with repair and restoration of the flexor-pronator origin, using a suture anchor. | 12 | MEPS 88 +/- 7.8 | 20% concomitant preoperative ulnar neuritis. Pronation weakness was noted in all cases pre-operatively. |
| Grawe et al (2016)18 | 31 | Debridement with repair and restoration of the flexor-pronator origin, using a suture anchor. | 40 (12 to 67) | QuickDASH 2.3 OES 45. Return to premorbid sporting activities at 4.5 mths. |
Older age at surgery predicted better DASH and OES. A shorter duration of symptoms was beneficial. 19% patients reported pre-operative symptoms of ulnar neuritis. |
MEPS, Mayo Elbow Performance Score; DASH, Disabilities of the Arm, Shoulder and Hand; OES, Oxford Elbow Score