Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort...

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation

Background:

• Lateral epicondylitis, commonly known as tennis elbow, presents a treatment challenge due to its self-limited yet often refractory nature.
• Identifying patients unlikely to respond to conservative management early is crucial for optimizing treatment pathways.

Purpose of the Study:

• To develop a predictive method for identifying lateral epicondylitis cases refractory to a wait-and-see approach.
• To utilize initial clinical indicators for predicting treatment outcomes in patients with lateral epicondylitis.

Main Methods:

• A cohort of 22 lateral epicondylitis patients using a resting orthosis was followed for 6 months.
• Grip strength ratios (affected/unaffected side) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were assessed at 6-week intervals.
• Receiver operating characteristic (ROC) curves analyzed initial measurements to determine cut-off values and prediction accuracy for refractory cases.

Main Results:

• Six-month post-treatment QuickDASH scores differed significantly between improved (2.3 ± 4.7) and refractory (25.9 ± 15.4) patients.
• A grip strength ratio ≤ 0.54 and a QuickDASH score ≥ 30 at initial consultation significantly predicted refractoriness.
• Achieving either cut-off value demonstrated a sensitivity of 1.0 for predicting refractory outcomes.

Conclusions:

• Patients with an initial grip strength ratio ≤ 0.5 or a QuickDASH score ≥ 30 are likely to have persistent symptoms 6 months after conservative treatment.
• These clinical indicators can guide early intervention decisions for lateral epicondylitis management.