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Lateral Elbow Tendinopathy: Development of a Pathophysiology-Based Treatment Algorithm.

Gev Bhabra¹, Allan Wang², Jay R Ebert³

¹Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Orthopaedic Journal of Sports Medicine

|November 12, 2016

Summary

This study introduces a grading system for lateral elbow tendinopathy (tennis elbow) based on its severity. It proposes a treatment algorithm to guide management for this common overuse injury.

Keywords:

biomechanics elbow histopathology lateral tendinopathy tendon healing tendon injury treatment

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Area of Science:

Orthopedics
Sports Medicine
Pathology

Background:

Lateral elbow tendinopathy, or tennis elbow, causes significant functional impairment.
Tendinopathy describes chronic overuse tendon disorders with diverse pathologies.
Current nonoperative treatments lack clear guidance for effective use.

Purpose of the Study:

To detail the pathophysiology of tendinopathy and tendon healing.
To introduce a system for grading tendinopathy severity based on histopathological features.
To propose a treatment algorithm for lateral elbow tendinopathy management.

Main Methods:

Review of pathophysiology and tendon healing principles.
Development of a 4-grade severity classification system for tendinopathy.
Correlation of pathophysiology with nonoperative treatment mechanisms.

Main Results:

The review details tendinopathy pathophysiology and healing.
A 4-grade system with distinct histopathological features is presented.
An algorithm links tendinopathy grade to nonoperative treatment selection.

Conclusions:

A severity-based grading system for lateral elbow tendinopathy is proposed.
The proposed algorithm aims to guide clinical management and future research.
This approach may improve treatment efficacy by categorizing patients.