Extracapsular subcutaneous endoscopic treatment for refractory medial epicondylitis: A case series of 14 patients

Purpose This study describes the technical approach for extracapsular endoscopic management of refractory medial epicondylitis and assesses patient outcomes based on postoperative follow-up. Methods This retrospective study analyzed data from 13 patients (mean age 46.4 years, range 26–66 years; 14 elbows involved) with definite refractory medial epicondylitis who underwent extra-articular arthroscopic surgery between January 2016 and October 2024. Exclusion criteria comprised infection, recent ipsilateral limb surgery, other joint diseases, and severe systemic disorders. Clinical outcomes were evaluated pre- and post-operatively using the visual analog scale for pain, medial epicondylar tenderness assessment, the disabilities of the arm, shoulder, and hand questionnaire, and the Mayo elbow performance score. Results No postoperative complications (e.g., infection) occurred. Histopathological analysis of debrided tissue from the medial epicondyle was performed in select cases. Of the 13 patients, 7 were lost to follow-up; and thus, outcome data were available for the remaining 6 patients. No postoperative follow-up data demonstrated favorable joint status, with a mean visual analog scale pain score of 1, mean medial epicondylar tenderness score of 1.5, mean Mayo elbow performance score of 85, and mean disabilities of the arm, shoulder, and hand score of 0.83. Conclusion In our cohort, extra-articular arthroscopy demonstrated a straightforward procedural workflow and yielded favorable outcomes in pain relief, reduced elbow tenderness, and functional restoration. These findings suggest that this technique is effective and safe for treating refractory medial epicondylitis in surgical candidates.