Tennis elbow, also known as external humerus epicondylitis, is a common orthopedic and sports medicine disease with a prevalence rate of 1%-3% in the population, and the age of onset is 35-50 years old. Clinically, the main symptoms are evident lateral elbow tenderness and limited elbow and wrist joint activity. Patients whose pain has not been significantly relieved after more than six months of conservative treatment are defined as having intractable tennis elbow, accounting for about 10% of the patients with tennis elbow. Wada et al. reported the first case of arthroscopic treatment of tennis elbow in 1995. After continuous clinical summaries and concept updates, total arthroscopic treatment of tennis elbow has gradually become a trend. In recent years, many studies believe that tennis elbow is tendinopathy near tendon insertion, and extensor carpi radialis brevis (ECRB) is the most commonly involved, and many clinical studies have achieved good results through arthroscopic ECRB surgical treatment. However, the exact evaluation of long-term clinical efficacy is rarely reported.

To investigate the application of arthroscopic reconstruction in treating intractable tennis elbow and its medium- and long-term clinical effects.

The data of 58 patients with intractable tennis elbow treated in Taizhou Bone Injury Hospital from January 2017 to December 2020 were retrospectively selected. According to different treatment methods, 32 patients with intractable tennis elbow who underwent arthroscopic debridement were included in the debridement group. Twenty-six patients with intractable tennis elbow who underwent arthroscopic reconstruction of ECRB were included in the reconstruction group. Using ECRB cross-sectional area, visual analogue scale (VAS), upper extremity functional index, UEFI, Mayo elbow performance score (MEPS), and postoperative complications were evaluated.

There was no significant difference in the general data between the two groups (P>0.05). The cross-sectional area of ECRB at different time nodes was separate (P<0.05), and the cross-sectional area of ECRB in the reconstruction group increased gradually at 6, 12, and 24 months after surgery. The cross-sectional area of ECRB decreased six months after the operation and increased steadily at 12 months and 24 months after the procedure. There was no significant difference in VAS, UEFI, and MEPS scores between the two groups before intervention (P>0.05). After the intervention, the VAS score in the reconstruction group was significantly lower than that in the debridement group (P<0.05), and UEFI and MEPS scores in the reconstruction group were considerably higher than that in the debridement group (P<0.05). The two groups had significant differences in VAS, UEFI, and MEPS scores (P<0.05). By pin-to-pair comparison within the group, the VAS score of the two groups was lower than that of the previous one. Still, the VAS score of the cleanup group was lower than that of the operation only six months after the procedure, and the difference was statistically significant (P<0.05). The UEFI and MEPS scores of the two groups were higher after the operation than before the procedure. Still, the UEFI and MEPS scores of the cleanup group were higher than before the operation, only six months after the procedure, and the difference was statistically significant (P<0.05). Postoperative complications such as nerve injury, tendon rupture, infection, and subcutaneous hematoma were not found on the second day after surgery, at discharge, 6 months, 12 months, and 24 months after surgery in both groups, and the safety was good.

Arthroscopic repair and reconstruction surgery for intractable tennis elbow has a satisfactory postoperative effect. It can effectively relieve patients' pain and promote the recovery of elbow joint function in the medium and long term, and it is safe and worthy of clinical application.