Name:
Arthroscopic Management of Lateral Epicondylitis
Description:
Arthroscopic Management of Lateral Epicondylitis
Thumbnail URL:
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Duration:
T00H06M41S
Embed URL:
https://stream.cadmore.media/player/a08a8a79-3573-4f2c-8012-37f0822f2a26
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/a08a8a79-3573-4f2c-8012-37f0822f2a26/ARTHROSCOPIC MANAGEMENT OF LATERAL EPICONDYLITIS.mp4?sv=2019-02-02&sr=c&sig=qfxBGzkjMsWKag7VyMM9ZJox%2BIpq%2BRmbihjZirqQYsQ%3D&st=2024-11-24T00%3A13%3A09Z&se=2024-11-24T02%3A18%3A09Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello, my friends, how are you? This is me, Dr. Sergio Rowinski, here from São Paulo, Brazil, from shoulder planet. And, in this video, I want to show you, guys, how to do an arthroscopic management of lateral epicondylitis, the surgical management of lateral epicondylitis, through arthroscopy.
We all know that the vast majority of the cases of lateral epicondylitis are managed non operatively. Nevertheless, some cases, as an exception, will deserve, as an exception, surgery, which can be done openly or arthroscopically. And this video is about the arthroscopic management of such cases. So I hope you like it.
Please subscribe. Give us your thumbs up. Leave your comment. And let's see the video. Lateral epicondylitis is a very common problem in the daily practice, in the office, especially for shoulder & elbow surgeons. As we all know, the great majority of these cases really do get better with conservative management, what includes anti-inflammatory medications, physical therapy and injections.
Anyway, something about 8 to 15 % of these cases will not succeed with conservative options. And, for these cases, surgery is quite often indicated. For many years, open treatment was the gold standard surgical technique. But in the last six years, arthroscopy has been widely utilised, and very good outcomes have already been reported. In this presentation, I'm going to show three cases operated in the last year, with very good outcomes.
So the patient is always put in a prone position, and then standard medial and lateral portals are established, and the patient always has general anesthesia. So this is the first surgery. This is a right elbow, we are establishing the lateral portal with a spinal needle, and then we are opening the capsule with a simple mosquito. And once the capsule is opened, we started to debride the pathologic tissue using a soft tissue shaver.
As we can see now, it's very easy to differentiate the pathologic tissue to the normal tissue. And now we are using electrocautery to remove all the angiofibroblastic tissue, and, as we can see now, it's very easy to see the normal fibers of the ECRB, that always lie behind the pathologic tissue. Now, almost all the pathologic tissue was removed.
Now we are just using a basket to remove the final part of the pathologic tissue, and, as we can see now, no more pathologic tissue is in place, and, at this moment, the surgery is then finished. This is the second case, a right elbow, too, in which we started with soft tissue shaver. As I have said, it's very easy to see that the color of the pathologic tissue is very different from the normal tissue.
Now we are seeing the capitellum, on the upper right side of the video, and we are using a soft tissue shaver. Now we start to see the normal fibers of the ECRB, just behind the pathologic tissue, and we still have to remove it. Now we are seeing the normal fibers of the ECRB. Some of them are most of the time released, as we are seeing, in this part of the video, and
now we are removing the final parts of the pathologic tissue, just very close to the capitellum. Now we are removing the very final part, and this is the final aspect of the surgery, in which we can see that all the pathologic tissue was very nicely removed. This is another case, a left elbow, and we can see all the pathologic tissue, here,
we are doing the same thing now, we are establishing the lateral portal with a spinal needle. Now we are opening the capsule, and starting to debride the pathologic tissue with a soft tissue shaver. Now, in this case, we can see the annular ligament, that was obviously not removed, but just debrided and, as I just have said, it's very easy to differentiate the pathologic tissue from the normal tissue.
Now we are seeing the normal fibers of the ECRB, and, in this case, we used a probe, as a retractor, as we can see in the right parts of the video. Now we are using an electrocautery to remove the upper part of the pathologic tissue, and it's very important to remove it, but not to damage the lateral collateral ligaments, that are lying in inferior part of the video,
In this particular case. Now we are using a basket to remove the remaining parts of the pathologic tissue, and this is the final aspect, in which we can see that all the pathologic tissue was removed. And, at that moment, the surgery was then finished. So in summary, arthroscopy has been proved, in the most recent years, to be a very safe, easy and reproducible way of treating lateral epicondylitis.
So, my friends, I hope you liked it. the arthroscopic management of lateral epicondylitis. So, please, don't forget. Subscribe, give us your thumbs up. We need your comments. Leave your comment. Show it to your friends. See you in the next video and, as Dr. Sergio always says, never stop flying.
See you, folks. Bye bye. See you...
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