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Lateral epicondylitis: tendinitis or tendinosis?

https://doi.org/10.47529/2223-2524.2022.1.9

Abstract

Lateral epicondylitis is a common pathology of the musculoskeletal system resulting from repeated microtrauma of the extensor muscles of the forearm and their tendons. Lateral epicondylitis was previously thought to be tendinitis, which is an inflammatory reaction in the tendon. However, histopathologically, it has been shown to be low in inflammatory elements: macrophages and neutrophils. Thus, it is now believed that this pathology is a tendinosis, which is defined as a degenerative rather than an inflammatory process.

About the Authors

A. S. Samoylov
Russian State Research Center — Burnasyan Federal Medical Biophysical Center
Russian Federation

Alexander S. Samoylov, M.D., D.Sc. (Medicine), Professor, Corresponding Member of the RAS, general director 

23, Marshal Novikov str., Moscow, 123098



M. V. Ivanov
Russian State Research Center — Burnasyan Federal Medical Biophysical Center
Russian Federation

Mark V. Ivanov, Assistant Professor of the Department of Rehabilitation Medicine, Sports Medicine, Balneology and Physiotherapy of Biomedical University of Innovation and Continuing Education

23, Marshal Novikov str., Moscow, 123098



N. R. Zhestyankin
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Nikita R. Zhestyankin, student

20, bld. 1, Delegatskaya str., Moscow, 127473



References

1. Runge F. Zur genese und behandlung des schreibekramfes. Berlin. Klin. Wochenschr. 1873;10:245–248 (In German).

2. Shiri R., Viikari-Juntura E., Varonen H., Heliovaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am. J. Epidemiol. 2016:164(11):1065–1074 https://doi.org/10.1093/aje/kwj325

3. Yi R., Bratchenko W.W., Tan V. Deep Friction Massage Versus Steroid Injection in the Treatment of Lateral Epicondylitis. Hand (NY). 2018;13(1):56–59. https://doi.org/10.1177/1558944717692088

4. Tarpada S.P., Morris M.T., Lian J., Rashidi S. Current advances in the treatment of medial and lateral epicondylitis. J. Orthop. 2018;15(1):107–110. https://doi.org/10.1016/j.jor.2018.01.040

5. Houck D.A., Kraeutler M.J., Thornton L.B., McCarty E.C., Bravman J.T. Treatment of Lateral Epicondylitis With Autologous Blood, Platelet-Rich Plasma, or Corticosteroid Injections: A Systematic Review of Overlapping Meta-analyses. Orthop. J. Sports Med. 2019;7(3):2325967119831052. https://doi.org/10.1177/2325967119831052

6. Dedes V., Tzirogiannis K., Polikandrioti M., Dede A.M., Mitseas A., Panoutsopoulos G.I. Comparison of radial extracorporeal shockwave therapy with ultrasound therapy in patients with lateral epicondylitis. J. Med. Ultrason (2001). 2020;47(2):319–325. https://doi.org/10.1007/s10396-019-01002-9

7. Descatha A., Albo F., Leclerc A., Carton M., Godeau D., Roquelaure Y., et al. Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis. Arthritis Care Res. (Hoboken). 2016;68:1681–1687. https://doi.org/10.1002/acr.22874

8. Clarke A.W., Ahmad M., Curtis M., Connell D.A. Lateral elbow tendinopathy: Correlation of ultrasound findings with pain and functional disability. Am. J. Sports. Med 2010;38(6):1209–1214. https://doi.org/10.1177/0363546509359066

9. Challoumas D., Kirwan P.D., Borysov D., Clifford C., McLean M., Millar N.L. Topical glyceryl trinitrate for the treatment of tendinopathies: A systematic review. Br. J. Sports Med. 2019;53(4):251–262. https://doi.org/10.1136/bjsports-2018-099552

10. Yan C., Xiong Y., Chen L., Endo Y., Hu L., Liu M., et al. A comparative study of the efficacy of ultrasonics and extracorporeal shock wave in the treatment of tennis elbow: a meta-analysis of randomized controlled trials. J. Orthop. Surg. Res. 2019;14(1):248. https://doi.org/10.1186/s13018-019-1290-y

11. Walton M.J., Mackie K., Fallon M., Butler R., Breidahl W., Zheng M.H., Wang A. The reliability and validity of magnetic resonance imaging in the assessment of chronic lateral epicondylitis. J. Hand Surg. Am. 2011;36(3):475–479. https://doi.org/10.1016/j.jhsa.2010.11.040

12. Sanders T.L., Kremers H.M., Bryan A.J., Ransom J.E., Smith J., Morrey B.F. The Epidemiology and Health Care Burden of Tennis Elbow. A Population-Based Study. Am. J. Sports Med. 2015;43(5):1066–1071. https://doi.org/10.1177/0363546514568087

13. Sayegh E.T., Strauch R.J. Does nonsurgical treatment improve longitudinal outcomes of lateral epicondylitis over no treatment? A meta-analysis. Clin Orthop Relat Res 2015;473(3):1093–107

14. Tarpada S.P., Morris M.T., Lian J., Rashidi S. Current advances in the treatment of medial and lateral epicondylitis. J. Orthop. 2018;15(1):107–110. https://doi.org/10.1016/j.jor.2018.01.040

15. Struijs P.A., Kerkhoffs G.M., Assendelft W.J., Van Dijk C.N. Conservative treatment of lateral epicondylitis: Brace versus physical therapy or a combination of both – A randomized clinical trial. Am. J. Sports Med. 2004;32(2):462–469. https://doi.org/10.1177/0095399703258714

16. Nirschl R.P. Tennis elbow. Orthop. Clin. North. Am. 1973;4(3):787–800.

17. Kannus P., Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon: a controlled study of 891 patients. J. Bone Joint Surg [Am]. 1991;73(10):1507– 1525. https://doi.org/10.2106/00004623-199173100-00009

18. Doran A., Gresham G.A., Rushton N., Watson C. Tennis elbow: a clinicopathologic study of 22 cases followed for 2 years. Acta Orthop. Scand. 1990;61(6):535–538. https://doi.org/10.3109/17453679008993577

19. Pattanittum P., Turner T., Green S., Buchbinder R. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database Syst. Rev. 2013;2013(5):CD003686. https://doi.org/10.1002/14651858.cd003686.pub2

20. Kraushaar B.S., Nirschl R.P. Tendinosis of the elbow (tennis elbow): clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J. Bone Joint Surg. [Am]. 1999;81(2):259–278. https://doi.org/10.2106/00004623-199902000-00014

21. Coombes B.K., Bisset L., Vicenzino B. A new integrative model of lateral epicondylalgia. Br. J. Sports Med. 2009;43(4):252– 258. https://doi.org/10.1136/bjsm.2008.052738

22. Arnoczky S.P., Tian T., Lavagnino M., et al. Activation of stress-activated protein kinases (SAPK) in tendon cells following cyclic strain: the effects of strain frequency, strain magnitude, and cytosolic calcium. J. Orthop. Res. 2002;20(5):947–952. https://doi.org/10.1016/s0736-0266(02)00038-4

23. Waugh E.J., Allander E. Lateral epicondy Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand. J. Rheumatol. 1974;3(3):145–153. https://doi.org/10.3109/03009747409097141


Review

For citations:


Samoylov A.S., Ivanov M.V., Zhestyankin N.R. Lateral epicondylitis: tendinitis or tendinosis? Sports medicine: research and practice. 2022;12(1):73-76. (In Russ.) https://doi.org/10.47529/2223-2524.2022.1.9

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