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Medial Epicondylitis

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Arthroscopy and Sport Injuries

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Abstract

Medial epicondylitis is one of the more common diagnoses in elbow pain. It occurs as a result of occupational activities and sports, mainly in athletes participating in sports that involve overhead throwing with valgus overload of the elbow.

Histologically, it involves tendon degeneration rather than inflammatory changes. Medial epicondylitis is a tendinopathy of the common flexor-pronator origin. It is the most common reason of medial elbow pain. Although the natural history of medial epicondylitis has not been well investigated, most cases of acute or subacute medial epicondylitis heal spontaneously.

Surgical treatment is required when this condition fails to respond to nonoperative methods such as rest, ice, drugs, physical therapy, injections, bracing and instrumental electrophysical modalities. Little has been published regarding operative techniques for medial epicondylitis. It is generally agreed that the same surgical principles used on the lateral side apply to the medial side: exposing the affected tendon and excising the pathologic portion. If medial epicondylitis treatments are unsuccessful, associated ulnar neuropathy or chronic ulnar collateral ligament insufficiency should be considered.

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References

  1. Kahn KM, Cook JL, Kannus P, Maffully N, Bonar SF (2002) Time to abandon the “tendinitis” mith, Painful, overuse tendon conditions have a non-inflammatory pathology. BMJ 324(7338):626

    Article  Google Scholar 

  2. Leach RE, Miller JK (1987) Lateral and medial epicondylitis of the elbow. Clin Sports Med 6:259–272

    CAS  PubMed  Google Scholar 

  3. Stahl S, Kaufman T (1997) The efficacy of an injection of steroids for medial epicondylitis: a prospective study of sixty elbows. J Bone Joint Surg Am 79(11):1648–1652

    CAS  PubMed  Google Scholar 

  4. Vangsness CT Jr, Jobe FW (1991) Surgical treatment of medial epicondylitis. Results in 35 elbows. J Bone Joint Surg 73B:409–411

    Google Scholar 

  5. Shaw HM, Benjamin M (2007) Structure-function relationships of enthuses in relation to mechanical load and exercise. Scan J Med Sci Sports 17(4):303–315

    Article  CAS  Google Scholar 

  6. Ollivierre CO, Nirschl RP, Pettrone FA (1995) Resection and repair for medial tennis elbow: a prospective analysis. Am J Sports Med 23(2):214–221

    Article  CAS  PubMed  Google Scholar 

  7. Gabel GT, Morrey BF (1995) Operative treatment of medial epicondylitis. J Bone Joint Surg 77A(7):1065–1069

    Google Scholar 

  8. Lee AT, Lee-Robinson AL (2010) The prevalence of medial epicondylitis among patients with c6 and c7 radiculopathy. Sports Health 2(4):334–336

    PubMed Central  PubMed  Google Scholar 

  9. Wright RW, Steger-May K, Klein SE (2007) Radiographic findings in the shoulder and elbow of Major League Baseball pitchers. Am J Sports Med 35:1839–1843

    Article  PubMed  Google Scholar 

  10. Miller TT, Adler RS, Friedman L (2004) Sonography of injury of the ulnar collateral ligament of the elbow-initial experience. Skeletal Radiol 33:386–391

    Article  PubMed  Google Scholar 

  11. Gy P, Lee SM, Lee MY (2008) Diagnostic value of ultrasonography for clinical medial epicondylitis. Arch Phys Med Rehabil 89(4):738–742

    Article  Google Scholar 

  12. Dewan AK, Chhabra AB, Khanna AJ, Anderson MW, Brunton LM (2013) MRI of the elbow: techniques and spectrum of disease: AAOS exhibit selection. J Bone Joint Surg Am 95(14):1–13

    Article  Google Scholar 

  13. Wenzke DR (2013) MR imaging of the elbow in the injured athlete. Radiol Clin North Am 51(2):195–213

    Article  PubMed  Google Scholar 

  14. Kijowski R, De Smet AA (2005) Magnetic resonance imaging findings in patients with medial epicondylitis. Skeletal Radiol 34(4):196–202

    Article  PubMed  Google Scholar 

  15. Hill NB Jr, Bucchieri JS, Shon F, Miller TT, Rosenwasser MP (2000) Magnetic resonance imaging of injury to the medial collateral ligament of the elbow: a cadaver model. J Shoulder Elbow Surg 9:418–422

    Article  PubMed  Google Scholar 

  16. Hoogvliet P, Randsdorp MS, Dingemanse R, Koes BW, Huisstede BM (2013) Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. Br J Sports Med 47(17):1112–1119

    Article  PubMed  Google Scholar 

  17. Chang HY, Wang CH, Chou KY, Cheng SC (2012) Could forearm Kinesio Taping improve strength, force sense, and pain in baseball pitchers with medial epicondylitis? Clin J Sport Med 22(4):327–333

    Article  PubMed  Google Scholar 

  18. Dingemanse R, Randsdorp M, Koes BW, Huisstede BM (2014) Evidence for the effectiveness of electrophysical modalities for treatment of medial and lateral epicondylitis: a systematic review. Br J Sports Med 48(12):57–65

    Article  Google Scholar 

  19. Lee SS, Kang S, Park NK, Lee CW, Song HS, Sohn MK, Cho KH, Kim JH (2012) Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Ann Rehabil Med 36(5):681–687

    Article  PubMed Central  PubMed  Google Scholar 

  20. Suresh SP, Ali KE, Jones H, Connell DA (2006) Medial epicondylitis: is ultrasound guided autologous blood injection an effective treatment? Br J Sports Med 40(11):935–939

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Halpern BC, Chaudhury S, Rodeo SA (2012) The role of platelet-rich plasma in inducing musculoskeletal tissue healing. HSS J 8(2):137–145

    Article  PubMed Central  PubMed  Google Scholar 

  22. Shahid M, Wu F, Deshmukh SC (2013) Operative treatment improves patient function in recalcitrant medial epicondylitis. Ann R Coll Surg Engl 95(7):486–488

    Article  CAS  PubMed  Google Scholar 

  23. Kurvers H, Verhaar J (1995) The results of operative treatment of medial epicondylitis. J Bone Joint Surg Am 77(9):1374–1379

    CAS  PubMed  Google Scholar 

  24. Kwon BC, Kwon YS, Bae KJ (2014) The fascial elevation and tendon origin resection technique for the treatment of chronic recalcitrant medial epicondylitis. Am J Sports Med 42(7):1731–1737

    Article  PubMed  Google Scholar 

  25. Baumgard SH, Schwartz DR (1982) Percutaneous release of the epicondylar muscles for humeral epicondylitis. Am J Sports Med 10(4):233–236

    Article  CAS  PubMed  Google Scholar 

  26. Cho BK, Kim YM, Kim DS, Choi ES, Shon HC, Park KJ, Lee EM (2009) Mini-open muscle resection procedure under local anesthesia for lateral and medial epicondylitis. Clin Orthop Surg 1(3):123–127

    Article  PubMed Central  PubMed  Google Scholar 

  27. Zonno A, Manuel J, Merrell G, Ramos P, Akelman E, DaSilva MF (2010) Arthroscopic technique for medial epicondylitis: technique and safety analysis. Arthroscopy 26(5):610–616

    Article  PubMed  Google Scholar 

  28. Conway JE, Jobe FW, Glousman RE, Pink M (1992) Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am 74:67–83

    CAS  PubMed  Google Scholar 

  29. Rohrbough JT, Altchek DW, Hyman J, Williams RJ 3rd, Botts JD (2002) Medial collateral ligament reconstruction of the elbow using the docking technique. Am J Sports Med 30:541–548

    PubMed  Google Scholar 

  30. Ciccotti MG, Charlton WPH (2001) Epicondylitis in the athlete. Clin Sports Med 20(1):77–93

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Servicio de Traumatología y C. Ortopédica, Hospital MAZ, Avda. Academia General Militar 74, Zaragoza, 50015, Spain

    José Luis Avila Lafuente

  2. Servicio de Traumatología y C. Ortopédica, Hospital Ramon y Cajal, Crtra. De Colmenar Viejo km 9,100, Madrid, 28034, Spain

    Miguel A. Ruiz Iban

  3. Servicio de Traumatología y C. Ortopédica, Hospital de Asepeyo, Calle Joaquin Cardenas 2, Coslada, Madrid, 28820, Spain

    Miguel García Navlet

  4. Servicio de Traumatología y C. Ortopédica, Hospital Clinic, Calle Villarroel 170, Barcelona, 08036, Spain

    Sergi Sastre Solsona

  5. Servicio de Traumatología y C. Ortopédica, Hospital Universitario Donostia, Paseo Dr. Beguiristain s/n, San Sebastian, Guipuzcua, 20014, Spain

    Ricardo Cuellar Gutiérrez

  6. Servicio de Traumatología y C. Ortopédica, Union De Mutuas, Avda. Del Lledó 69, Castellón, 12004, Spain

    Eduardo Sánchez Alepuz

Authors
  1. José Luis Avila Lafuente
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  2. Miguel A. Ruiz Iban
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  3. Miguel García Navlet
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  4. Sergi Sastre Solsona
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  5. Ricardo Cuellar Gutiérrez
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  6. Eduardo Sánchez Alepuz
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Correspondence to José Luis Avila Lafuente .

Editor information

Editors and Affiliations

  1. Knee Orthopedics and Sport Traumatology Unit,, Humanitas Clinical Institute IRCCS, Milan, Italy

    Piero Volpi

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Lafuente, J.L.A., Iban, M.A.R., Navlet, M.G., Solsona, S.S., Gutiérrez, R.C., Alepuz, E.S. (2016). Medial Epicondylitis. In: Volpi, P. (eds) Arthroscopy and Sport Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-14815-1_27

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  • DOI: https://doi.org/10.1007/978-3-319-14815-1_27

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14814-4

  • Online ISBN: 978-3-319-14815-1

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