Editorial Commentary: Arthroscopic Elbow Arthritis Treatment With Osteocapsular Debridement Yields Favorable Results: On Second Thought, the Elbow Isn't That Unforgiving.

The elbow has been referred to as the unforgiving joint. Arthroscopy for treating elbow arthritis is both challenging and rewarding. Most joints require arthroplasty for treatment of arthritis, but the elbow is amenable to osteocapsular debridement. This is especially beneficial when elbow arthroplasty options have high complication rates and the need for permanent physical limitations. Thus, when treating arthritis, the elbow is more forgiving than once thought.

Editorial Commentary: Yet Another Arrow in the Quiver for Surgical Treatment of the Rotator Cuff-Deficient Shoulder: Will It Fly Fast and Far or Fall Short Like Other Options Have?

Rotator cuff tears are common. When indicated, surgical repair is a highly successful procedure. There are circumstances when there is not enough tendon to perform an anatomic repair because of tear size, retraction, and/or atrophy. This clinical scenario, massive irreparable rotator cuff tear, has no perfect solution. Many options exist in treating massive irreparable rotator cuff tears: partial tendon repairs, debridement, tuberoplasty, intercalary allograft repairs, tendon transfers, superior capsular reconstruction, hemiarthroplasty, arthrodesis, and reverse total shoulder arthroplasty. No superior technique has been described. Another treatment has been added to this list: inserting a biodegradable balloon within the subacromial space to reduce the articulation of the humeral head on the acromion and aid in recentering the humeral head to restore balance to the remaining rotator cuff and improve deltoid function.

Tendinosis of the extensor carpi radialis brevis: an evaluation of three methods of operative treatment.

Many procedures have been described for treating lateral epicondylitis with good success. The purpose of this report is to compare 3 operative methods for treatment of recalcitrant lateral epicondylitis-open, arthroscopic, and percutaneous. All patients with lateral epicondylitis who were operated on over a 7-year period were retrospectively reviewed. A minimum of 3 months of conservative care before surgery had failed in these patients, and they had a minimum of 2 years of follow-up. Concomitant pathology, complications, and necessary further care were noted. The outcomes were evaluated preoperatively and postoperatively with the Andrews-Carson score and visual analog scale scores for pain at rest, worst pain, and pain with activity. We included 109 patients in the study: 24 percutaneous, 44 arthroscopic, and 41 open procedures. The mean duration of conservative care was 13.2 months, including 2.5 conservative measures and 1.35 cortisone injections. The mean follow-up was 47.8 months. The preoperative Andrews-Carson score was 160.3. The postoperative Andrews-Carson score was 195. There was a statistically significant difference between preoperative and postoperative Andrews-Carson scores for each of the groups. There were no significant differences among the populations regarding age, gender, dominance, conservative measures used, cortisone injections, recurrences, complications, failures, visual analog scale scores, and preoperative and postoperative Andrews-Carson scores. In addition, no difference in outcome scores was noted when intraarticular and concomitant pathology was addressed in comparison to the population in which tendinosis alone was addressed. Open, arthroscopic, and percutaneous treatments of lateral epicondylitis offer 3 highly effective ways for the clinician to address this common clinical problem.