APEX Elbow Mastering Surgical Techniques for Clinical Success-Tennis Elbow, Elbow Tendinopathy

Video Transcription

Video Summary

Surgeons discuss elbow arthroscopy strategy and then shift to tennis elbow management. For elbow osteoarthritis, they recommend starting anteriorly to minimize morbidity: anterior work is harder to do later when swelling increases, while the posterior approach can remain small and minimally invasive. They describe using cannulas and a safe technique for capsular release by sweeping a metal cannula proximally and elevating the capsule off the humerus, avoiding full capsule excision.<br /><br />For tennis elbow, three MRI cases illustrate a spectrum from low-grade partial extensor tendon tear to near-complete tear with possible ligament involvement. The group emphasizes that most lateral elbow pain is non-surgical; initial care focuses on education, activity modification, NSAIDs/ice, and therapy, with cautious, limited steroid use. They stress ruling out mimickers (distal biceps pathology, instability, plica, arthritis, radial tunnel). Surgical pearls include precise portal placement with a spinal needle, protecting the lateral ulnar collateral ligament by staying above the radiocapitellar equator, debridement/decortication, selective repair, and favoring knotless anchors. Risk factors for failure include multiple steroid injections, obesity, tobacco, and osteoarthritis.

Asset Caption

Moderator: S. Joshua Szabo, M.D.

Keywords

elbow arthroscopy

elbow osteoarthritis

anterior capsular release technique

lateral epicondylitis (tennis elbow) management

extensor tendon tear MRI spectrum

lateral ulnar collateral ligament protection