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Arthroscopic Plication Of The Radial Component Of The Lateral Collateral Ligament For Symptomatic Minor Instability Of The Lateral Elbow (Smile).

Arthroscopic Plication Of The Radial Component Of The Lateral Collateral Ligament For Symptomatic Minor Instability Of The Lateral Elbow (Smile).

Paolo Angelo Arrigoni, MD, ITALY Davide Cucchi, MD, GERMANY Alessandra Menon, MD, ITALY Carlo Eugenio Zaolino, MD, ITALY Alberto Aliprandi, MD, Prof., ITALY Francesco Luceri, MD, ITALY Pietro S. Randelli, MD, Prof., ITALY

IRCCS Policlinico San Donato, ASST Gaetano Pini, Milano, ITALY


2021 Congress   Abstract Presentation   7 minutes   rating (2)

 

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Sports Medicine

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Summary: Minor instability is a possible aetiology of lateral elbow pain and arthroscopic plication of the radial component of the lateral collateral ligamen produces subjective satisfaction and positive clinical results at 2-year median follow-up


Background

Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow.

Methods

Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra- articular abnormal finding. Single-assessment numeric evaluation (SANE), Oxford Elbow Score (OES), quick- DASH (Disabilities of the Arm, Shoulder, Hand), patient satisfaction and post-operative range of motion were evaluated. The Shapiro–Wilk normality test was used to evaluate the normal distribution of the sample. Differences between pre- and post-operative SANE score were analysed with an unpaired Wilcoxon matched-pairs signed rank test.

Results

SANE improved from a median of 30 [2–40] points pre-operatively to 90 [80–100] at final follow-up (p < 0.0001), and 96.3% patients obtained good or excel- lent subjective results. Post-operative median quickDASH was 9.1 [0–25] points and OES 42 [34–48]. Median post-operative flexion was 145°, and extension was 0°. Post- operative flexion was restrained in seven patients and extension in eight patients; 59% of patients reached full ROM at final follow-up.

Conclusions

R-LCL plication produces subjective satisfaction and positive clinical results in patients presenting with a symptomatic minor instability of the lateral elbow (SMILE) at 2-year median follow-up. A slight limitation in range of motion is a possible undesired consequence of this intervention.


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