Lateral epicondylitis - In vivo assessment of arthroscopic debridement and correlation with patient outcomes

Background: Surgical management of lateral epicondylitis has traditionally consisted of an open incision with debridement of the affected extensor tendon tissue. More recently, arthroscopy has been reported as a surgical option for this condition. Purpose: To evaluate the effectiveness of arthroscopic debridement in excising the characteristic tendinopathy of chronic lateral epicondylitis and determine if residual tendinopathy correlated with poorer patient outcomes. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected on all patients who underwent arthroscopic debridement of chronic lateral epicondylitis during a 2-year period. The arthroscopic debridement was assessed in regard to its effectiveness in excising the characteristic tendinopathy through a traditional open procedure by gross and histologic analysis. Outcomes data were collected on all patients preoperatively and at a minimum of 1 year postoperatively. Patient outcomes were then correlated with the residual histologic tendinopathy after arthroscopic debridement. Results: Eighteen patients were enrolled in the investigation. Gross evidence of residual tendinopathy was identified in 6 patients, with all 6 cases occurring during the first year of the study. Of the 18 patients, 10 had residual histologic evidence of tendinopathy after arthroscopic debridement. Poorer outcomes were identified in those patients who had residual histologic tendinopathy on their rating of worst level of pain (P = .03). Conclusion: Residual microscopic tendinopathy is often present after arthroscopic debridement. Clinically, residual microscopic tendinopathy correlated with poorer surgical outcomes in regard to patient's rating of their worst level of pain.