Arthroscopic resection of the common extensor origin: anatomic considerations.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Lateral epicondylitis, commonly known as tennis elbow, is a degenerative condition affecting the common extensor origin.
• Arthroscopic approaches offer minimally invasive treatment options for lateral epicondylitis.

Purpose of the Study:

• To define the intra-articular anatomy and safe resection zones for arthroscopic debridement of the common extensor origin.
• To evaluate the extent of resectable tendinous origin and its effect on elbow stability.

Main Methods:

• Arthroscopic debridement of the extensor complex in 7 cadaveric elbows.
• Assessment of elbow stability and determination of safe resection boundaries.
• Quantification of resected portions of extensor carpi radialis brevis and extensor digitorum communis origins.

Main Results:

• Mean resection of extensor carpi radialis brevis origin was 100%; extensor digitorum communis origin was 90%.
• Elbow stability was maintained when resection stayed anterior to the radial head's axis.
• Posterolateral rotatory instability occurred with posterior extension of debridement beyond the radial head axis.

Conclusions:

• Complete arthroscopic resection of the common extensor origin (extensor carpi radialis brevis-extensor digitorum communis) is feasible.
• Maintaining elbow stability requires avoiding debridement posterior to the radial head's bisecting line.
• The lateral ulnar collateral ligament integrity is preserved with adherence to safe resection zones.