Late Surgical Results of Reattachment to Bone in Repair of Chronic Lateral Epicondylitis
Mark E. Pruzansky, MD, George D. Gantsoudes, MD, and Nathan Watters, BA
Dr. Pruzansky is Assistant Clinical Professor of Orthopaedic Surgery, and Dr. Gantsoudes is a Resident, Department of Orthopaedic Surgery, Mount Sinai School of Medicine, New York, New York.
Mr. Watters is a graduate of Washington University, St. Louis, Missouri.
All cases of lateral epicondylitis surgically treated in Dr. Pruzansky’s office practice between October 1986 and December 2005 yielded 24 elbows for this study. Patients were treated with surgical débridement and direct repair to bone through bone tunnels (18 elbows), repair with suture anchors (3 elbows), or augmentation with autologous tendon graft and reattachment to bone via suture anchors (3 elbows).
This series represents the earliest reattachment cases to be reported, and with the longest follow-up. Mean follow-up (both telephone and office interviews) was 64.7 months. All patients reported satisfaction and graded their outcomes as good or excellent. Mean time to full painless preinjury level of use of the elbow was 4.3 months for patients who underwent simple repair and 2.75 months for patients repaired with a graft. Surgical reattachment of the débrided extensor tendon of origin of the elbow to bone, either directly or with autologous tendon graft, provided pain relief and return to preinjury level of function in a predictable manner.
Both primary repair and tendon graft procedures can be used in primary and salvage surgeries in tennis elbow cases in which conservative treatment fails.