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Double-Row Repair for Recalcitrant Medial Epicondylitis
BACKGROUND: Various techniques have been described for surgical treatment of recalcitrant medial epicondylitis (ME). No single technique has yet to be proven the most effective. PURPOSE: To evaluate the clinical outcomes of a double-row repair for ME. STUDY DESIGN: Case series; Level of evidence, 4....
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928541/ https://www.ncbi.nlm.nih.gov/pubmed/31903395 http://dx.doi.org/10.1177/2325967119885608 |
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author | Wu, Victor J. Thon, Stephen Finley, Zachary Bohlen, Hunter Schwartz, Zachary O’Brien, Michael J. Savoie, Felix H. |
author_facet | Wu, Victor J. Thon, Stephen Finley, Zachary Bohlen, Hunter Schwartz, Zachary O’Brien, Michael J. Savoie, Felix H. |
author_sort | Wu, Victor J. |
collection | PubMed |
description | BACKGROUND: Various techniques have been described for surgical treatment of recalcitrant medial epicondylitis (ME). No single technique has yet to be proven the most effective. PURPOSE: To evaluate the clinical outcomes of a double-row repair for ME. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective review was performed on 31 consecutive patients (33 elbows) treated surgically for ME with a minimum clinical follow-up of 2 years. All patients were initially managed nonoperatively with anti-inflammatories, steroid injections, topical creams, and physical therapy. Outcome measures at final follow-up included visual analog scale (VAS) scores (scale, 0-10), time to completely pain-free state, time to full range of motion (FROM), Mayo Elbow Performance Scores (MEPS), and Oxford Elbow Scores (OES). Patients were contacted by telephone to determine current functional outcomes, pain, activity, functional limitations, and MEPS/OES. Successful and unsuccessful outcomes were determined by the Nirschl grading system. RESULTS: The mean clinical and telephone follow-up periods were 2.3 and 3.6 years, respectively, and 31 of 33 (94%) elbows were found to have a successful outcome. The mean VAS improvement was 4.9 points, from 5.8 preoperatively to 0.9 postoperatively (P < .001). The mean MEPS and OES at final follow-up were 95.1 and 45.3, respectively. The mean time to pain-free state and time to FROM were 87.4 and 96 days, respectively. Unlike prior studies, no difference in outcome was found between those with and without ulnar neuritis preoperatively (P = .67). CONCLUSION: A double-row repair is effective in decreasing pain and improving the overall function for recalcitrant ME. Uniquely, the presence of preoperative ulnar neuritis was associated with higher patient-reported preoperative pain scores but not with poor outcomes using this protocol. |
format | Online Article Text |
id | pubmed-6928541 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-69285412020-01-03 Double-Row Repair for Recalcitrant Medial Epicondylitis Wu, Victor J. Thon, Stephen Finley, Zachary Bohlen, Hunter Schwartz, Zachary O’Brien, Michael J. Savoie, Felix H. Orthop J Sports Med Article BACKGROUND: Various techniques have been described for surgical treatment of recalcitrant medial epicondylitis (ME). No single technique has yet to be proven the most effective. PURPOSE: To evaluate the clinical outcomes of a double-row repair for ME. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective review was performed on 31 consecutive patients (33 elbows) treated surgically for ME with a minimum clinical follow-up of 2 years. All patients were initially managed nonoperatively with anti-inflammatories, steroid injections, topical creams, and physical therapy. Outcome measures at final follow-up included visual analog scale (VAS) scores (scale, 0-10), time to completely pain-free state, time to full range of motion (FROM), Mayo Elbow Performance Scores (MEPS), and Oxford Elbow Scores (OES). Patients were contacted by telephone to determine current functional outcomes, pain, activity, functional limitations, and MEPS/OES. Successful and unsuccessful outcomes were determined by the Nirschl grading system. RESULTS: The mean clinical and telephone follow-up periods were 2.3 and 3.6 years, respectively, and 31 of 33 (94%) elbows were found to have a successful outcome. The mean VAS improvement was 4.9 points, from 5.8 preoperatively to 0.9 postoperatively (P < .001). The mean MEPS and OES at final follow-up were 95.1 and 45.3, respectively. The mean time to pain-free state and time to FROM were 87.4 and 96 days, respectively. Unlike prior studies, no difference in outcome was found between those with and without ulnar neuritis preoperatively (P = .67). CONCLUSION: A double-row repair is effective in decreasing pain and improving the overall function for recalcitrant ME. Uniquely, the presence of preoperative ulnar neuritis was associated with higher patient-reported preoperative pain scores but not with poor outcomes using this protocol. SAGE Publications 2019-12-23 /pmc/articles/PMC6928541/ /pubmed/31903395 http://dx.doi.org/10.1177/2325967119885608 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Wu, Victor J. Thon, Stephen Finley, Zachary Bohlen, Hunter Schwartz, Zachary O’Brien, Michael J. Savoie, Felix H. Double-Row Repair for Recalcitrant Medial Epicondylitis |
title | Double-Row Repair for Recalcitrant Medial Epicondylitis |
title_full | Double-Row Repair for Recalcitrant Medial Epicondylitis |
title_fullStr | Double-Row Repair for Recalcitrant Medial Epicondylitis |
title_full_unstemmed | Double-Row Repair for Recalcitrant Medial Epicondylitis |
title_short | Double-Row Repair for Recalcitrant Medial Epicondylitis |
title_sort | double-row repair for recalcitrant medial epicondylitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928541/ https://www.ncbi.nlm.nih.gov/pubmed/31903395 http://dx.doi.org/10.1177/2325967119885608 |
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