Purpose
To qualify and quantify the changes in magnetic resonance imaging (MRI) signals in
the extensor tendons after arthroscopic debridement for lateral epicondylitis and
evaluate the association between MRI findings and temporal clinical results by comparisons
between recovered and unrecovered cases.
Methods
Thirty-four patients with refractory lateral epicondylitis treated with arthroscopic
debridement were divided into recovered (n = 24) and unrecovered (n = 10) groups according
to the Japanese Orthopaedic Association-Japan Elbow Society score. This study included
any patients who underwent both the pre- and postoperative MRI and excluded patients
with a previous history of any elbow surgery. Pre- and postoperative MRI findings
were qualitatively categorized into 4 grades, quantified by measuring the percentage
of tendinopathy area, and compared between the groups.
Results
Preoperatively, grading scores and percentages did not show significant differences
between groups (P = .050 and .519). The respective numbers of patients with grades 1, 2, 3, and 4 were
1 (4%), 3 (13%), 10 (42%), and 10 (42%) in the recovered group; and 1 (10%), 2 (20%),
7 (70%), and 0 (0%) in the unrecovered group. The average percentages in the recovered
and unrecovered groups were 42.3% (73.9 mm2/168.4 mm2); and 36.5% (50.5 mm2/131.0 mm2). However, postoperatively, they were significantly lower in the recovered group
than in the unrecovered group (P = .007 and .014). The numbers and percentages in the recovered and unrecovered groups
were 15 (63%), 8 (33%), 1 (4%), and 0 (0%) and 17.0% (28.6mm2/169.8mm2) and 2 (20%), 3 (30%), 5 (50%), and 0 (0%) and 30.5% (39.0 mm2/131.8 mm2).
Conclusions
Qualitative and quantitative MRI is useful for evaluating the progress of tendon healing
after arthroscopic debridement. In the recovered and unrecovered groups, improvement
of tendinopathy area were 60% versus 16%, indicating that postoperative MRI findings
reflect clinical outcomes.
Level of Evidence
IV, case series with subgroup analysis.
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Article info
Publication history
Published online: August 10, 2022
Accepted:
July 13,
2022
Received:
January 22,
2022
Footnotes
See commentary on page 3130
The authors report the following potential conflicts of interest or sources of funding: This study was supported by Japan Society for the Promotion of Science, Japan KAKENHI (Grant Number JP 21K16684). ICMJE author disclosure forms are available for this article online, as supplementary material.
Investigation was performed at the Japan Community Health Care Organization Osaka Hospital, Osaka, Japan.
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© 2022 by the Arthroscopy Association of North America
