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: email@example.com).