Editorial Commentary: For Refractory Elbow Lateral Epicondylitis, Patients Do Well After Excision of the Diseased Part of the Extensor Carpi Radialis Brevis, Regardless of Open or Arthroscopic Technique, Debridement Alone, or Debridement With Repair.

Abstract

Lateral epicondylitis is a common cause of elbow pain and disability, resulting from degenerative tendinosis of the extensor carpi radialis brevis origin at the lateral epicondyle. This condition is generally self-limiting, with activity modification, physical therapy, and injections serving as the first-line treatments. Surgery is typically reserved for patients experiencing ongoing pain and disability that impact daily living or recreational activities, despite extensive conservative management for at least 6 months, ideally over 12 months. With time and patience, over 90% of patients achieve symptom resolution within 12 to 18 months using nonoperative modalities. For patients with refractory symptoms, surgical treatment offers favorable outcomes, with over 90% patient satisfaction and improvement rates, regardless of whether the surgical procedure is performed arthroscopically or in an open manner, using debridement alone or debridement with repair. The key is excision of the diseased portion of the extensor carpi radialis brevis.