Abstract: Lateral epicondylitis (LE) is a significant source of pain and dysfunction resulting from repetitive gripping or wrist extension, radial deviation, and/or forearm supination. Although most cases are self-limiting over several years, controversy exists regarding the best treatment strategy for chronic LE. Nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy (PT), shockwave therapy, and injections with corticosteroids or biologics are all conservative treatment options for LE. For refractory cases, surgical options include open, arthroscopic, and percutaneous techniques. In this review, the current evidence behind these treatment strategies is presented. The data demonstrate that NSAIDs, PT, bracing, and shockwave therapy provide limited benefit for treating LE. Biologics such as platelet-rich plasma and autologous whole-blood injections may be superior to steroid injections in the long-term management of LE. Although the initial results are promising, larger comparative studies on stem cell injections are needed. For refractory LE, open, arthroscopic, and percutaneous techniques are all highly effective, with no method seemingly superior over another. Arthroscopic and percutaneous approaches may result in faster recovery and earlier return to work.

Keywords: lateral epicondylitis, tennis elbow, shockwave, injection, biologics, platelet-rich plasma, stem cells, surgery


中文翻译：

---

慢性外侧上con炎：挑战和解决方案

摘要：外侧上con炎（LE）是反复抓握或腕部伸展，radial骨偏斜和/或前臂旋后引起的疼痛和功能障碍的重要原因。尽管大多数情况在几年内都是自限性的，但关于慢性LE的最佳治疗策略仍存在争议。非甾体抗炎药（NSAIDs），物理疗法（PT），冲击波疗法以及皮质类固醇或生物制剂的注射都是LE的保守治疗选择。对于难治性病例，手术选择包括开放式，关节镜和经皮技术。在这篇综述中，介绍了这些治疗策略背后的当前证据。数据表明，NSAID，PT，支架和冲击波疗法对LE的治疗作用有限。在LE的长期治疗中，诸如富含血小板的血浆和自体全血注射剂之类的生物制剂可能优于类固醇注射剂。尽管初步结果令人鼓舞，但仍需要对干细胞注射进行更大的比较研究。对于难治性LE，开放式，关节镜和经皮技术都是非常有效的，似乎没有一种方法比其他方法更优越。关节镜和经皮入路可能会加快恢复速度，并提早恢复工作。

关键词：外侧上con炎，网球肘，冲击波，注射，生物制剂，富血小板血浆，干细胞，手术