Purpose
To compare complication rates and 5-year reoperation rates between open debridement
(OD) and arthroscopic debridement (AD) for lateral epicondylitis.
Methods
The PearlDiver MUExtr database (2010-2019) was reviewed for patients diagnosed with
lateral epicondylitis (queried by International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision [ICD-10] codes) undergoing OD or AD of the common extensor tendon without repair (queried
by Current Procedural Terminology codes). Patients were stratified into 2 cohorts: those who underwent AD and those
who underwent OD. Nonoperative treatment modalities were reported for both groups
within 1 year before index procedure. The rates of 90-day postoperative complications
were compared, and multivariate logistic regression analysis was used to identify
risk factors for complications. The 5-year reoperation rates, using laterality-specific
ICD-10 codes, were also compared between the 2 groups.
Results
In total, 19,280 patients (OD = 17,139, AD = 2,141) were analyzed in this study. The
most common nonoperative treatments for patients who underwent OD or AD were corticosteroid
injections (49.5% vs 43.2%), physical therapy (24.8% vs 25.7%), bracing (2.8% vs 3.2%),
and platelet-rich plasma injections (1.3% vs 1.0%). There were no significant differences
in radial nerve injuries, hematomas, surgical site infections, wound dehiscence, and
sepsis events between the 2 procedures (P = .50). The 5-year reoperation rate was not significantly different between the AD
(5.0%) and OD (3.9%) cohorts (P = .10).
Conclusions
For lateral epicondylitis, both AD and OD of the extensor carpi radialis brevis (without
repair) were found to have low rates of 90-day adverse events, with no significant
differences between the 2 approaches. Similarly, the 5-year reoperation rate was low
and not statistically different for those treated with OD or AD.
Level of Evidence
Level III, cross-sectional study.
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Article info
Publication history
Published online: August 29, 2022
Accepted:
August 14,
2022
Received:
April 7,
2022
Footnotes
See commentary on page 253
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Investigation performed at the Hospital for Special Surgery, Weil-Cornell Medical School, New York, New York, U.S.A.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
