Arthroscopic Findings in Refractory Lateral Epicondylitis
DOI:
https://doi.org/10.63403/re.v33i2.486Keywords:
Epicondylitis, Elbow arthroscopy, Synovial plica, Osteochondral lesions, Elbow instabilityAbstract
Introduction: refractory lateral epicondylitis is traditionally considered a degenerative tendinopathy of the extensor carpi radialis brevis. However, increasing evidence suggests that persistent lateral elbow pain often results from associated intra-articular pathology.
Objectives: to describe the arthroscopic findings in a series of patients with refractory lateral epicondylitis and to analyze their clinical relevance.
Materials and methods: a retrospective, descriptive study was conducted including patients who underwent elbow arthroscopy between 2017 and 2025 due to refractory lateral elbow pain. Patients operated on for other primary indications were excluded. Arthroscopic findings were systematically recorded, including extensor carpi radialis brevis (ECRB) tendinopathy, synovial plica, osteochondral lesions, and lateral collateral ligament complex insufficiency. Osteochondral lesions were classified according to the Bradley classification. Data were analyzed descriptively.
Results: seventy-eight patients met the inclusion criteria. The mean age was 46.5 ± 7.8 years, with a predominance of male patients. ECRB tendinopathy was identified in 46 patients (59%). Osteochondral lesions were observed in 49 patients (63%), with 24 lesions classified as Bradley grade III (49%) and 25 as grade IV (51%). Synovial radiocapitellar plica was the most frequent finding, present in 71 patients (91%). Signs of lateral collateral ligament complex insufficiency were observed in 41 patients (53%). Synovial plica resection was performed in 71 patients (91%), and tendon and/or ligament repair using anchors in 40 patients (51%).
Conclusion: refractory lateral epicondylitis represents a multifactorial condition frequently associated with intra-articular pathology. Elbow arthroscopy allows comprehensive evaluation and treatment of the lesions responsible for persistent lateral elbow pain.
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Copyright (c) 2026 Guillermo Maujo, Melissa A. Edelmann Carrillo, Joaquín Pison, Giovani Ballerini
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