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Introduction: Medial epicondylitis, often called golfer's elbow, involves pain on the inner side of the elbow. It usually results from repetitive strain on the tendons that connect the forearm muscles to the medial epicondyle. While commonly linked to golfing, it can affect people engaged in various activities requiring repetitive wrist flexion and gripping. Purpose of work: This paper aims to provide a comprehensive overview of the pathogenesis, imaging characteristics, and treatment strategies for medial epicondylitis. State of knowledge: Medial epicondylitis can be worsened by activities that require forceful gripping, such as golfing or weightlifting [1][2]. The condition has been extensively studied and is well-documented in the scientific literature. Various treatments are available, including conservative methods like rest, physical therapy, and injections, as well as surgical interventions for persistent cases. Material and methods: This review draws upon an in-depth analysis of current scientific literature, including recent publications in prominent medical journals and relevant research studies. To identify pertinent scientific publications and research studies, comprehensive searches were conducted on widely recognized academic databases, such as PubMed and Google Scholar. Summary: Medial epicondylitis, also known as "golfer's elbow," is characterized by pain and tenderness over the bony prominence on the inner side of the elbow. It often results from repetitive strain or overuse of the muscles that flex the wrist and pronate the forearm [3]. Diagnostic imaging, such as X-rays and MRI, can help evaluate this condition [1][4]. Treatment typically involves a combination of conservative approaches, including rest, physical therapy, and anti-inflammatory medications, as well as more invasive options like corticosteroid injections or surgery for persistent cases.

Introduction Tennis Elbow, known also as Lateral Epicondylitis (LE) is a very common overuse injury affecting not only tennis players. Mainly, it causes pain, weakness in grip strength and difficulties with daily activities. Most patients are successfully treated with non-surgical methods but some of them eventually require surgical intervention. Aim of study The objective of this study is to evaluate both surgical and non-surgical treatment methods for Tennis Elbow and seeks to introduce doctors and patients to the assets and downsides associated with them. State of Knowledge Tennis Elbow occurs in 1-3% of adults, most likely when frequently performing repeated movements of flexion and extension of the elbow. At the early stages inflammation is present, after that the vascular hyperplasia and active fibroblasts occur. Most common risk factors are manual labour, ipsilateral rotator cuff tear, ipsilateral Carpal Tunnel Syndrome (CTS), female sex, dominant-side involvement, and hypertriglyceridemia. Summary (Conclusion) There is a wide range of available conservative treatment methods for Lateral Epicondylitis including physical therapy, various injections, and medication. They should be considered as the first line treatment showing high success rate for mild and moderate cases. Surgical methods have high success rates as well though they are considered more invasive and performed only on chronic patients. Best approach ought to be carefully selected for each patient based on severity of symptoms and patient needs.

Biceps brachii distal tendon injury is rare, 2.55–5.35 per 100,000. This nosological form did not have a gender modality and was previously found mainly in middle-aged men (46.3 y.o.). By 2022, this injury “rejuvenated” and began to occur more often, covering the categories of juniors and young athletes, whose professional activities have expanded significantly with the advent of new power disciplines, contact sports and popularization of bodybuilding. The authors note the negative impact of smoking and the use of anabolic steroids, statins and obesity on the incidence of these lesions. The maximum supination force in this type of injury is reduced by an average of 40 %, and the maximum flexion force is reduced by an average of 20 %. Considering the significance of functional disorders not only of the elbow joint, but also of motor patterns of the entire upper limb girdle for professional athletes, sports-organized people and people involved in the physical aspects of labor, surgical treatment is recommended. Nonsurgical treatment can be aimed at suppressing edema and inflammation, limiting early movements in the elbow joint and increasing secondary muscle tension, and it is suitable for patients with low functional demand, poor compliance and high risks of both surgical treatment and anesthesia care. That is, the choice of treatment tactics is still based, in addition to anatomical changes and on the “subjective” patient data, his/her needs for physical activity and requires an algorithmic approach in order to avoid both known complications and confidently predict a positive result during the prehospital period. Based on ten years of clinical and practical experience adjusted by widely available scientific periodicals, we have developed a scheme that is understandable to every specialist in the field of traumatology, orthopedics or sports medicine, and is applicable regardless of the medical institution level. For the first time, this scheme was published in this work.

The review article explores recent advances in the surgical treatment of elbow pain, a common ailment that can significantly impair daily functioning. With a surge in elbow-related conditions such as tennis elbow, osteoarthritis, and nerve compression disorders, the necessity for surgical approaches has become paramount. This article provides an overview of the cutting-edge procedures now available, including minimally invasive arthroscopic surgery. These modern methods have been shown to significantly reduce recovery times and improve overall patient outcomes. The combination of surgical management and targeted rehabilitation ensures a comprehensive and personalized treatment plan for patients with various elbow pathologies. This article aims to shed light on these recent surgical interventions and their potential for advancing the management of elbow pain, emphasizing the ongoing trend toward precision, efficiency, and patient-centered care.

Pain originating from the elbow can be due to issues affecting the joint itself or the structures surrounding it. These structures include the medial and lateral epicondyles, associated ligaments, the origins of wrist flexor and extensor muscles, the olecranon bursa, the distal biceps tendon, and the radial and ulnar nerves. Pain that appears to originate from a different location may actually be referred pain, potentially stemming from the neck (cervical radiculopathy) or the shoulder. Among complaints related to the elbow, lateral elbow pain is the most frequently reported. This pain could originate from the lateral epicondyle, the radiohumeral joint, or it could be referred pain from other areas. Medial elbow pain is the second most common complaint, often resulting from issues with the medial epicondyle or the ulnar nerve as it travels through the cubital tunnel. The biceps tendon is frequently the cause of anterior elbow pain. Patients who report swelling in the elbow are often experiencing olecranon bursitis. These conditions can often be effectively managed through conservative treatment. The aim of this article is to provide a structured approach to addressing patients with elbow pain, by detailing the common causes of such discomfort and exploring effective nonsurgical treatment options.

Abstract Background Lateral epicondylitis is one of the most common upper extremity problems presented to orthopedic surgeons. Despite a rapid and accurate arrival at a diagnosis by clinical examination, there exists no consensus classification for this condition, which hampers clinical approaches for treatment of the disease based on its severity. Thus, the aim of this study was to propose and valiadate a new magnetic resonance imaging (MRI) classification of lateral epicondylitis, staging by tendinosis, the degree of thickness tears of the common extensor tendon (CET) and bone bruise lesion. Method MRI assessment of the elbow of 75 patients (57 women and 18 men; mean age:51.4 years (range,34–73) from Jan 2014 to Jan 2021 who were diagnosed with lateral epicondylitis were included in the study. MR images were reviewed retrospectively by two independent upper extremities orthopedists and one musculoskeletal radiologist. Inter- and intra-observer reliabilities for the classification were calculated using kappa statistics for the analysis of interrater agreement. Correlation between the stage of the disease and the duration of symptom before MRI was calculated using Kruskal–wallis test. Results Various degrees of CET lesions were demonstrated in this population (Stage I-17, IIA-7, IIB-22 and III-29). Intra-observer agreements of MRI staging were substantial to satisfactory. Inter-observer agreements were moderate to substantial. There was no significant correlation between the disease stage and the patient age or the duration of symptom before MRI. Conclusion Our MRI classification has emerged as one of the most reliable methods to define stages of chronic lateral epicondylitis. At the end, we have suggeted a clearer direction for understanding the disease pathology as well as an appropriate management protocol for each stage of the disease in line with the recent body of literature.

Upper limb tennis injuries are primarily chronic, resulting from repetitive overuse. We developed a wearable device which simultaneously measures risk factors (grip strength, forearm muscle activity, and vibrational data) associated with elbow tendinopathy development resulting from tennis players’ technique. We tested the device on experienced (n = 18) and recreational (n = 22) tennis players hitting forehand cross-court at both flat and topspin spin levels under realistic playing conditions. Using statistical parametric mapping analysis, our results showed that all players showed a similar level of grip strength at impact, regardless of spin level, and the grip strength at impact did not influence the percentage of impact shock transfer to the wrist and elbow. Experienced players hitting with topspin exhibited the highest ball spin rotation, low-to-high swing path brushing action, and shock transfer to the wrist and elbow compared to the results obtained while hitting the ball flat, or when compared to the results obtained from recreational players. Recreational players exhibited significantly higher extensor activity during most of the follow through phase compared to the experienced players for both spin levels, potentially putting them at greater risk for developing lateral elbow tendinopathy. We successfully demonstrated that wearable technologies can be used to measure risk factors associated with elbow injury development in tennis players under realistic playing conditions.

Abstract Objectives To determine the efficacy of platelet-rich plasma (PRP) compared to lidocaine as a tenotomy adjuvant for people with elbow tendinopathy. Methods Our study was a parallel-group, double-blind, randomized trial involving 71 patients with recalcitrant elbow tendinopathy who received two sessions of ultrasound-guided tenotomy with either PRP or lidocaine in a tertiary public hospital. The primary end point was the percentage of patients with an improvement exceeding 25% reduction in disability (Spanish version of the Disabilities of the Arm, Shoulder and Hand questionnaires–DASH-E) at 6 and 12 months; the secondary outcome was the percentage of patients exceeding 25% reduction in pain (VAS-P). Results There was no evidence of significant differences in the proportion of patients who experienced clinically relevant improvements. After 6 months, 18 patients (78.59%) in the lidocaine group and 19 patients (73.08%) in the PRP group showed improved function above 25% (unadjusted odds ratio, 0.90; 95% confidence interval [CI], 0.90 (0.17 to 4.60)); 21 patients (72.21%) in the lidocaine group versus 22 patients (84.62%) in the PRP group achieved more than 25% pain reduction (unadjusted odds ratio, 0.48; 95% CI, 0.10 to 2.37). After 12 months, 17 patients (70.83%) in the lidocaine group versus 19 patients (76%) in the PRP group had improved function (unadjusted odds ratio, 0.71; 95% CI, 0.13 to 3.84), and 19 patients (76%) in the lidocaine group versus 20 patients (90.91%) in the PRP group had improved pain above 25% (unadjusted odds ratio, 0.35; 95% CI, 0.06 to 2.51). Hypercholesterolemia and baseline vascularization influenced outcomes. There were no differences between groups in the adjusted odds ratios. Conclusion PRP results in similar improvements to those obtained with lidocaine. Selecting patients according to their pretreatment status can improve treatment efficacy. Trial registration NCT01945528, EudraCT 2013-000478-32. Registered 18 August 2013, enrolment of the first participant 10 March 2014