Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis
Background: Lateral epicondylitis is the most common cause of lateral elbow pain in adults, and nonoperative treatment is the first-line management modality of choice. Pain refractory to conservative management may improve with surgical interventions involving extensor carpi radialis brevis débridem...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638324001221 |
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| author | Misty Suri, MD, MS Arjun Verma, BS Collyn O’Quin, MD Gregory Parker, MD Kareem Mohamed, MD Hunter Starring, MD Daniel Yoo, MD |
| author_facet | Misty Suri, MD, MS Arjun Verma, BS Collyn O’Quin, MD Gregory Parker, MD Kareem Mohamed, MD Hunter Starring, MD Daniel Yoo, MD |
| author_sort | Misty Suri, MD, MS |
| collection | DOAJ |
| description | Background: Lateral epicondylitis is the most common cause of lateral elbow pain in adults, and nonoperative treatment is the first-line management modality of choice. Pain refractory to conservative management may improve with surgical interventions involving extensor carpi radialis brevis débridement or denervation. This investigation was conducted to evaluate the long-term analgesic efficacy, incidence of postoperative sensory deficits, and postoperative elbow functionality in patients who underwent a denervation surgery of the posterior branch of the posterior cutaneous nerve of the forearm (PBPCNF) for refractory lateral epicondylitis. Methods: This investigation was an institutional review board–approved, single-center, single-surgeon case series of 22 patients who underwent denervation surgery with an average final follow-up of 4.7 years. Inclusion criteria for surgery were a minimum of 6 months symptom duration refractory to conservative therapies, a minimum of 2 years clinical follow-up, and significant (70-80%) pain relief from the nerve block test. Visual Analog Scale pain and Single Assessment Numeric Evaluation scores were used to assess pain and function, respectively. The incidence of postoperative sensory deficits was evaluated via clinical exam. Results: Compared to the preoperative average, the cohort’s mean Visual Analog Scale pain was significantly decreased at all postoperative follow-up intervals, including 2 weeks, 1 year, and final average follow-up of 4.7 years. At the final follow-up, the mean Single Assessment Numeric Evaluation score was 98.8 ± 2.6, and one patient (4.5%), who reported the same sensory deficit preoperatively, reported postoperative sensory deficits. Conclusion: The PBPCNF denervation procedure is a highly efficacious procedure for achieving long-term pain control in the treatment of refractory lateral epicondylitis. The PBPCNF denervation procedure affords patients a high level of postoperative functionality with a low incidence of sensory deficits. |
| format | Article |
| id | doaj-art-1204aa67da6744e7b5e12453de3fc47e |
| institution | Kabale University |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-1204aa67da6744e7b5e12453de3fc47e2025-01-12T05:25:55ZengElsevierJSES International2666-63832025-01-0191226230Denervation procedure of the lateral epicondyle for refractory lateral epicondylitisMisty Suri, MD, MS0Arjun Verma, BS1Collyn O’Quin, MD2Gregory Parker, MD3Kareem Mohamed, MD4Hunter Starring, MD5Daniel Yoo, MD6Department of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, New Orleans, LA, USA; Corresponding author: Misty Suri, MD, MS, Department of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, 1201 South Clearview Pkwy, Building B, Suite 100, New Orleans, LA 70121, USA.Department of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, New Orleans, LA, USADepartment of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, New Orleans, LA, USADepartment of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, New Orleans, LA, USADepartment of Orthopedic Surgery, The Ochsner Andrews Sports Medicine Institute, Ochsner Health System, New Orleans, LA, USADepartment of Orthopedic Surgery, Ochsner Health System, Jefferson, LA, USAJaneda Orthopedics, Queens, NY, USABackground: Lateral epicondylitis is the most common cause of lateral elbow pain in adults, and nonoperative treatment is the first-line management modality of choice. Pain refractory to conservative management may improve with surgical interventions involving extensor carpi radialis brevis débridement or denervation. This investigation was conducted to evaluate the long-term analgesic efficacy, incidence of postoperative sensory deficits, and postoperative elbow functionality in patients who underwent a denervation surgery of the posterior branch of the posterior cutaneous nerve of the forearm (PBPCNF) for refractory lateral epicondylitis. Methods: This investigation was an institutional review board–approved, single-center, single-surgeon case series of 22 patients who underwent denervation surgery with an average final follow-up of 4.7 years. Inclusion criteria for surgery were a minimum of 6 months symptom duration refractory to conservative therapies, a minimum of 2 years clinical follow-up, and significant (70-80%) pain relief from the nerve block test. Visual Analog Scale pain and Single Assessment Numeric Evaluation scores were used to assess pain and function, respectively. The incidence of postoperative sensory deficits was evaluated via clinical exam. Results: Compared to the preoperative average, the cohort’s mean Visual Analog Scale pain was significantly decreased at all postoperative follow-up intervals, including 2 weeks, 1 year, and final average follow-up of 4.7 years. At the final follow-up, the mean Single Assessment Numeric Evaluation score was 98.8 ± 2.6, and one patient (4.5%), who reported the same sensory deficit preoperatively, reported postoperative sensory deficits. Conclusion: The PBPCNF denervation procedure is a highly efficacious procedure for achieving long-term pain control in the treatment of refractory lateral epicondylitis. The PBPCNF denervation procedure affords patients a high level of postoperative functionality with a low incidence of sensory deficits.http://www.sciencedirect.com/science/article/pii/S2666638324001221Tennis elbowLateral epicondylitisDenervationElbow arthroscopySensory disturbanceCutaneous nerve |
| spellingShingle | Misty Suri, MD, MS Arjun Verma, BS Collyn O’Quin, MD Gregory Parker, MD Kareem Mohamed, MD Hunter Starring, MD Daniel Yoo, MD Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis JSES International Tennis elbow Lateral epicondylitis Denervation Elbow arthroscopy Sensory disturbance Cutaneous nerve |
| title | Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| title_full | Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| title_fullStr | Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| title_full_unstemmed | Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| title_short | Denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| title_sort | denervation procedure of the lateral epicondyle for refractory lateral epicondylitis |
| topic | Tennis elbow Lateral epicondylitis Denervation Elbow arthroscopy Sensory disturbance Cutaneous nerve |
| url | http://www.sciencedirect.com/science/article/pii/S2666638324001221 |
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