外側上顆炎に対する関節鏡視下および開放外側リリース術の有効性の比較：疼痛、機能、回復を評価するランダム化試験

The optimal surgical treatment for lateral epicondylitis remains debated, while arthroscopic lateral release offers theoretical benefits over the traditional open approach. This study aimed to compare arthroscopic versus open technique in early and long-term outcomes. In this study, 45 patients with chronic lateral epicondylitis underwent arthroscopic (n = 23) and open lateral release (n = 22). The primary outcome was the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. Secondary outcomes included the visual analog scale (VAS) for pain, Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score, time to return to work, operative time, scar satisfaction, and complications from postoperative day 1 through 12 months. Both surgical techniques significantly improved pain and function without complications at 12 months. However, the arthroscopic group demonstrated superior early outcomes. At 1 month, PRTEE scores were significantly lower in the arthroscopic group (mean 0.47 ± 0.10 vs. 0.75 ± 0.10; P < 0.05). VAS score was markedly reduced from day 1 through 1 month (P < 0.05), with a mean day 1 difference of -2.7 (95% CI -2.90 to -2.03). qDASH scores also favored arthroscopy at week 1 (mean 13.2 vs. 21.3; P < 0.05), returned to full-duty work significantly earlier (mean 2.3 vs. 12.9 weeks; P < 0.05), and reported higher scar satisfaction (mean 5.0 vs. 4.63; P < 0.05). The open technique had significantly shorter operative time (30.5 vs. 40.6 min.; P < 0.05). Both surgical techniques are effective and safe. The arthroscopic approach had significant early advantages, including reduced pain, quicker return to work, and superior cosmetic satisfaction. These findings support arthroscopic release as a preferred option for patients prioritizing early recovery and minimal invasiveness. Level of Evidence Level I.