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Outcomes of Continued Intensive Conservative Treatment Versus Arthroscopic Extensor Carpi Radialis Brevis Release for Recalcitrant Lateral Epicondylitis: A Non-randomized Controlled Trial

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Abstract

Introduction

There is no consensus on treatment of recalcitrant lateral epicondylitis (RLE). This is a prospective, non-randomized, interventional study comparing pain scores and functional outcomes between arthroscopic extensor carpi radialis brevis release and continued intensive conservative treatment.

Materials and Methods

The study compared two groups: Group 1, consisting of 25 patients undergoing continued conservative treatment for 24 months, and Group 2, consisting of 25 patients undergoing arthroscopic extensor carpi radialis brevis release with decortication (ARD). VAS (Visual Analogue Scale) score for lateral elbow pain at rest and after routine daily activities were compared at 6 weeks, 24 weeks, 12 months and 24 months. Functional outcomes were compared with grip strength, and patients reported functional outcome scores, pre-intervention and 24 months post-intervention.

Results

There was a significant improvement in VAS scores for pain, functional outcome scores, and grip strength in both the groups post-intervention (P < 0.05). VAS scores for pain at rest in both the groups were significantly better after the interventions, at all follow-up durations (P < 0.001). VAS scores for pain after routine daily activities were significantly better in group 2 at 24 weeks (P = 0.002) and afterward (P < 0.001). Group 2 had significantly better functional outcome scores at 24 months (P < 0.001) though the difference in grip strength was not statistically significant (P = 0.121).

Conclusion

The present study shows favourable functional outcomes and pain scores of ARD compared to continued intensive conservative treatment for RLE.

Level of Study

II, Non-randomized comparative study.

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Availability of Data and Materials

The datasets used and/or analyzed during the current study may be available from the corresponding author on reasonable request. Data regarding this study is not available in any electronic databases.

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Acknowledgements

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India

    Tarun Goyal

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

    Arghya Kundu Choudhury, Souvik Paul, Siddharth S. Sethy & Vivek Singh

  3. Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Rishikesh, India

    Raj Kumar Yadav

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Contributions

TG—planning of study, writing and revising the manuscript. AKC—data collection, outcome assessment, manuscript preparation. SP—literature search, writing the manuscript, outcome assessment. SS—data management, outcome assessment, manuscript preparation. VS—planning of study, writing and revising the manuscript. RY—planning of study, writing and revising the manuscript.

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Correspondence to Tarun Goyal.

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Goyal, T., Choudhury, A.K., Paul, S. et al. Outcomes of Continued Intensive Conservative Treatment Versus Arthroscopic Extensor Carpi Radialis Brevis Release for Recalcitrant Lateral Epicondylitis: A Non-randomized Controlled Trial. JOIO 56, 1578–1586 (2022). https://doi.org/10.1007/s43465-022-00649-w

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