Ultrasound-guided tenotomy of the common extensor tendon in the elbow: a cadaveric investigation

This study aimed to evaluate the efficacy and safety of a novel ultrasound-guided percutaneous tenotomy technique for treating chronic tendinosis of the common extensor tendon (CET) in the elbow (lateral epicondylitis).

The study was conducted on 25 elbows from 13 cadavers without prior local injuries. Each CET tenotomy was performed using a Mikro 64 scalpel under ultrasound guidance to ensure precision and safety. Key anatomical structures, including the lateral collateral ligament (LCL), radial nerve, and posterior antebrachial cutaneous nerve, were monitored to assess safety margins and detect potential complications.

In the 20 evaluated cases, the mean distance from the CET section to the radial epicondyle (DET) was 5.86 mm (range 5.96-12.8 mm), while the distance to the proximal LCL margin (DELCL) averaged 8.62 mm (range - 0.96-6.82 mm), yielding a confident tenotomy length of 2.76 mm. Partial LCL injury occurred in four cases without affecting joint stability, and no nerve injuries were observed. Incomplete CET sections were found in four cases, with residual fibers primarily along the medial and lateral margins.

The ultrasound-guided percutaneous tenotomy technique demonstrated safety and effectiveness in an anatomical setting. This minimally invasive approach may offer a viable surgical alternative for refractory lateral epicondylitis, minimizing the risk of complications and promoting a shorter recovery period.