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Objectives: Lateral epicondylitis (LE) is one of the most common elbow conditions in adults. Symptoms of chronic LE can cause severe discomfort and/or physical disability that is economically burdening to patients and health care costs. The purpose of this study is to assess treatment outcomes of pain and function for refractory extensor carpi radialis brevis (ECRB) tendinosis after tendon fenestration with and without platelet-rich plasma (PRP). Design: Retrospective case series. Methods: A specialized orthopaedic hospital conducted a retrospective medical chart review of 33 patients from January 1, 2016-December 31, 2017. The study included 27 patients diagnosed with ECRB tendinosis treated with ultrasound-guided ECRB fenestration with 1% lidocaine/normal saline or PRP. The numeric pain rating scale (NPRS) and Patient-Rated Elbow Evaluation (PREE) were used for quantitative assessment of pain and function. Results: After one lidocaine/saline injection with fenestration (LSIF), 15% of patients (age mean: 50.5 ± 8.7, range: 41-62) with LE showed improvement in pain and function. After two LSIF, 59% of patients (age mean: 54.8 ± 5.1, range: 47-67) with LE showed improvement in pain and function. The patients having a superimposed partial ECRB tendon tear benefited from an additional one LSIF and two leukocyte-poor platelet-rich plasma injections with fenestration (PRPIF), with 26% of this particular group of LE patients (age mean: 52.9 ± 5.2, range: 44-60) showing improvement in pain and function. Conclusions: Tendon fenestration is safe and effective in 75% of our patients who failed conservative treatment for ECRB tendinosis. The presence of a partial ECRB tear is an indicator that fenestration alone was not as effective as a PRP injection with fenestration.

The Role of Needle Fenestration with Platelet-Rich Plasma in Chronic Tennis Elbow with Indication of Partial Extensor Tendon Tear