Tennis elbow, also known as lateral epicondylitis, is one of the most common causes of elbow joint pain. When conservative treatment fails to alleviate symptoms for more than six months, it is referred to as refractory tennis elbow, necessitating surgical intervention. Surgical options commonly include open surgery, percutaneous methods, and arthroscopic procedures. Open surgery involves more substantial trauma, while percutaneous techniques may affect postoperative outcomes due to difficulties in precise localization. Arthroscopic extensor carpi radialis brevis (ECRB) release, on the other hand, is gaining favor among surgeons due to its minimal invasiveness, clear intraoperative visualization, precise targeting, and rapid postoperative recovery. However, due to the prolonged learning curve associated with elbow arthroscopy, relatively few institutions in China are performing this procedure, resulting in limited literature on the subject.

To investigate the clinical effect of extensor carpi radialis brevis (ECRB) myotendolysis combined with joint debrideation by elbow arthroscopy in treating intractable tennis elbow.

A retrospective analysis of 18 cases treated with elbow arthroscopy for tennis elbow were conducted in our hospital between January 2021 and December 2022. Eight males and ten females were included, with ages ranging from 29 to 58 years and an average age of 42.4 years. All underwent arthroscopic release of the extensor carpi radialis brevis tendon at its attachment on the humerus, along with debridement of the elbow joint. Clinical efficacy was evaluated by comparing the Mayo elbow performance score (MEPS), and visual analogue scale (VAS) scores preoperatively and at 4 weeks, 3 months, 6 months, and final follow-up, combined with patient satisfaction.

All 18 cases were followed up for 6 to 24 months, with an average of 12.5 months. No complications such as wound infection, nerve or vascular damage, or elbow joint instability were observed postoperatively. The MEPS and VAS scores showed significant improvement compared to preoperative levels at 4 weeks, 3 months, 6 months, and the final follow-up (P<0.05). However, there was no significant difference in MEPS and VAS scores between 3 months, 6 months, and the final follow-up when compared to the scores at 4 weeks postoperatively (P>0.05). Of the 18 cases, 15 were highly satisfied, and 3 were satisfied, resulting in a satisfaction rate of 100%.

Elbow arthroscopic release of the extensor carpi radialis brevis (ECRB) combined with joint debridement is an effective treatment for refractory tennis elbow. It involves minimal surgical trauma and allows for rapid postoperative functional recovery, making it an effective and reliable surgical approach.