Advantages of 70° arthroscope in management of ECRB tendinopathy

Lateral epicondylitis requires a challenging therapeutic management even for expert surgeons. With the failure of conservative treatment, the physician should consider a surgical choice. The purpose of the surgical procedure is to excise the degenerated tissue of extensor carpi radialis brevis tendon. This article describes the arthroscopic release, performed under direct visualization with a 70° scope; the aim is to encourage the use of this type of lens, versus the traditional 30° one. The patient is positioned in a modified lateral decubitus. After joint distension, a diagnostic arthroscopy of the posterior compartment is performed as first step. Then, an anterior compartment arthroscopic evaluation, a subsequent antero-lateral capsulectomy, and extensor carpi radialis brevis tendon exposition are performed with a 30° view. At this point, the 70° lens is switched and the tendon release is performed under direct control. The 70° lens allows a safer procedure, but requires a dedicated learning curve.