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High-grade Common Extensor Tendon Tears Maintaining Chronic Lateral Epicondylitis

Clinical and Structural Outcome Following Knotless Suture Anchor Repair

Glanzmann, Michael C. MD*; Gleich, Johannes MD*; Rickenbacher, Dominik MSc*,†; Oswald, Jürg MD; Kolling, Christoph MD*,†; Audigé, Laurent PhD*,†

Techniques in Shoulder & Elbow Surgery: December 2019 - Volume 20 - Issue 4 - p 116–120
doi: 10.1097/BTE.0000000000000179

We describe the reconstruction of high-grade extensor tendon tears using a knotless suture anchor and hypothesize that this will result in improved elbow pain and function with a high healing rate. Twenty chronic lateral epicondylitis patients with magnetic resonance imaging–confirmed high-grade extensor tendon tears underwent surgery using a knotless suture anchor technique. All underwent clinical and ultrasound assessments and completed the quick Disabilities of the Arm, Shoulder, and Hand and patient-rated tennis elbow evaluation questionnaires at final follow-up. Preoperative and postoperative Mayo Elbow Performance Scores were also determined. Mean patient age at surgery was 48 years with 11 women and 7 men available at final follow-up. Diagnostic arthroscopy was performed for all patients before repair; cartilage lesions were found in 8 patients. Mayo Elbow Performance Score improved from 55 to 100 points. At final follow-up, the median grip strength was 100% (range, 52 to 114) of the nonaffected side and patient-rated scores were almost 0. We did not observe any retears. Some tennis elbow patients may present with high-grade tears that contribute to chronic symptoms. Our repair technique resulted in a satisfactory outcome for these patients and may reduce the risk of secondary posterolateral instability following complete tendon release.

*Upper Extremities Department

Research and Development Department

Rheumatology Department, Schulthess Clinic, Zurich, Switzerland

Institutional Review Board/Ethics Committee Approval was granted by the following institution: Cantonal Ethics Committee of Zurich, Stampfenbachstrasse 121/Postfach, 8090 Zurich. Approval for analyses of the local clinical register (KEK-ZH Nr. 2017–02255) was granted on February 19, 2018.

Support for this research was provided by the Schulthess Clinic.

The authors declare no conflict of interest.

Reprints: Michael C. Glanzmann, MD, Upper Extremities Department, Schulthess Clinic, Lengghalde 2, Zurich CH-8008, Switzerland (e-mail:

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