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Elbow tendinopathy: tennis elbow.
Robert P Nirschl1, Edward S Ashman
1Georgetown University Medical Center, 4000 Reservoir Road, Washington, DC 20057, USA. nirschl@erols.com
Clinics in Sports Medicine
|October 17, 2003
Summary
Overuse tendinopathy involves angiofibroblastic tendinosis, not inflammation. Nonoperative treatment focuses on rehabilitative resistance exercise to heal damaged elbow tendons, with surgery as a successful alternative if needed.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Pathoanatomy
Background:
- Overuse tendinopathy is characterized by noninflammatory angiofibroblastic tendinosis.
- Specific elbow regions affected include the ECRB-EDC complex, pronator teres, flexor carpi radialis, and triceps.
Purpose of the Study:
- To outline the pathoanatomy of elbow overuse tendinopathy.
- To describe nonoperative and operative treatment goals and methods.
Main Methods:
- Review of the pathoanatomic features of overuse tendinopathy.
- Description of nonoperative treatment principles focusing on exercise.
- Overview of surgical interventions for refractory cases.
Main Results:
- The pathoanatomy is angiofibroblastic tendinosis, affecting specific elbow structures.
- Nonoperative treatment aims to revitalize tendinotic tissue through progressive resistance exercise.
- Surgical interventions demonstrate high success rates when conservative treatment fails.
Conclusions:
- Understanding the specific pathoanatomy of elbow tendinopathy is crucial for targeted treatment.
- Rehabilitative resistance exercise is the cornerstone of nonoperative management.
- Surgical options provide a successful alternative for persistent tendinopathy.