Epicondylar resection with anconeus muscle transfer for chronic lateral epicondylitis.

A retrospective evaluation of 61 patients surgically treated for persistent lateral epicondylitis, covering the 8-year period between 1982 and 1990, was conducted. The study compared a group of patients treated by limited surgical resection of the lateral extensor aponeurosis with a group of patients treated by wide surgical excision of the aponeurosis and coverage by a vascularized rotational pedicle flap of the anconeus muscle. This is a new procedure that uses the vascular pedicle of the anconeus muscle, rotating it into the defect created by the wide excision. Evaluation at an average of 48 months after surgery indicates that compared with the limited surgical resection group, a higher percentage of patients in the anconeus muscle transfer group were able to perform strenuous activities with complete or near-complete pain relief. A higher percentage also returned to work or to normal activities; 94% of the patients were satisfied with the results of the procedure. This study indicates that this is an effective primary operative treatment for lateral epicondylitis when conservative treatment has failed. It also is effective in patients who continue to have persistent pain and inability to perform normal activities after previous lateral epicondylar release or resection.