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Updated: Mar 31, 2026
A Protocol to Acquire the Degenerative Tenocyte from Humans
Published on: June 9, 2018
[Chronic lateral epicondylitis : The Nirschl procedure]
A Müller1, C K Spies2, F Unglaub3,4
1Abteilung für Schulter- und Ellenbogenchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland. axel.mueller@vulpiusklinik.de.
Purpose:
Reduction of burden insufficiency.
Indication:
Chronic lateral epicondylitis.
Contraindications:
Acute infection in the surgical area. C6/7 nerve root and plexus irritation. Frohse Arcade syndrome. Posterolateral rotatory instability.
Surgical Technique:
Incision slightly cranial to the radial epicondyle. Identification of the extensor carpi radial brevis tendon (ERCB) and longus (ECRL). Mobilisation of the ECRL tendon, identification of degenerative tendons of the ECRB. Excision of degenerative tissue. Drill holes in the area of the smoothed radial epicondyle, thermal denervation.
Postoperative Management:
Arm plaster splint for 14 days. Unrestricted activity after 4-6 weeks. Maximum loading after 6 months.
Results:
Of the 24 consecutively operated patients, 83.3 % were included. High patient satisfaction. Nirschl tennis and elbow score improved from 35 to 75 points postoperatively. Pain levels decreased from 6.8 to 1.4 points postoperatively.
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