Epikondylitis
Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:Lino Witte
Definition:
Schmerzen am Epicondylus lateralis oder medialis des Ellenbogens.
Häufigkeit:
Die Epicondylitis lateralis ist die häufigste Tendinopathie des Menschen.
Symptome:
Durch Überbelastung ausgelöste Schmerzen an der Seite des Ellbogens, die oft in den Unterarm Richtung Handgelenk ausstrahlen.
Befunde:
Die laterale Epikondylitis verursacht Schmerzen bei isometrischer Extension des Handgelenks, die mediale Epikondylitis bei isometrischer Flexion.
Diagnostik:
Zusätzliche Untersuchungen sind in der Regel nicht erforderlich.
Therapie:
Die Behandlung erfolgt bei hohem Selbstheilungspotenzial konservativ mit u. a. Verzicht auf schmerzauslösende Aktivitäten und weiteren Maßnahmen wie Bewegungstherapie.
- Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e. V. (DGOU). Epicondylopathia radialis humeri. AWMF-Leitlinie Nr. 187-052. S2k, Stand 2019. www.awmf.org
- Watts AC, Robinson P. Epicondylitis. BestPractice, last updated April 2018. bestpractice.bmj.com
- De Smedt T, De Jong A, Van Leemput W, et al. Lateral epicondylitis in tennis: update on aetiology, biomechanics and treatment. Br J Sports Med 2007; 41(11): 816–819. www.ncbi.nlm.nih.gov
- Young CC. Medial Epicondylitis. Medscape, last updated Jan 24, 2019. emedicine.medscape.com
- Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e.V. (DGOU). Epicondylopathia radialis humeri. S2k, AWMF-Leitlinie Nr. 187-052. Stand 2019. www.awmf.org
- Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol 2006; 164(11): 1065-74. www.ncbi.nlm.nih.gov
- Hautmann MG, Beyer LP, Süß C et al. Radiotherapy of epicondylitis humeri. Strahlenther Onkol 2019; 195: 343-51. link.springer.com
- Wiggins AJ, Cancienne JM, Camp CL, et al. Disease Burden of Medial Epicondylitis in the USA Is Increasing: An Analysis of 19,856 Patients From 2007 to 2014. HSS J 2018; 14(3): 233-37. www.ncbi.nlm.nih.gov
- Fedorczyk JM. Tennis elbow: blending basic science with clinical practice. J Hand Ther 2006; 19(2): 146-53. www.ncbi.nlm.nih.gov
- Houck DA, Kraeutler MJ, Thornton LB, et al. 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. www.ncbi.nlm.nih.gov
- Owens BD. Lateral Epicondylitis (Tennis Elbow) Surgery. Medscape, last updated April 29, 2019. emedicine.medscape.com
- Van Rijn RM, Huisstede BM, Koes BW, et al. Associations between work-related factors and specific disorders at the elbow: a systematic literature review. Rheumatology (Oxford) 2009; 48(5): 528-36. www.ncbi.nlm.nih.gov
- McHardy A, Pollard H, Luo K. One-year follow-up study on golf injuries in Australian amateur golfers. Am J Sports Med 2007; 35(8): 1354-60. www.ncbi.nlm.nih.gov
- Vicenzino B, Brooksbank J, Minto J, et al. Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther 2003; 33(7): 400-7. www.ncbi.nlm.nih.gov
- Pattanittum P, Turner T, Green S, Buchbinder R. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD003686. DOI: 10.1002/14651858.CD003686.pub2. DOI
- Smidt N, van der Windt DA, Assendelft WJ, et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet 2002; 359: 657-62. PubMed
- Hoogvliet P, Randsdorp MS, Dingemanse R, et al. Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review.. Br J Sports Med 2013; 47(17): 1112-9. www.ncbi.nlm.nih.gov
- Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil. 2014 ;28(1):3-19. doi: 10.1177/0269215513491974. DOI
- Mafi N, Lorentzon R, Alfredson H. Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 2001; 9: 42-7. PubMed
- Jafarian FS, Demneh ES, Tyson SF. The immediate effect of orthotic management on grip strength of patients with lateral epicondylosis. J Orthop Sports Phys Ther 2009; 39(6): 484-9. www.ncbi.nlm.nih.gov
- Chen X, Jones IA, Park C, et al. The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment. Am J Sports Med 2017 Dec 1.363546517743746 pmid:29268037 PubMed
- Arirachakaran A, Sukthuayat A, Sisayanarane T, et al. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis. J Orthop Traumatol 2016; 17(2): 101-12. www.ncbi.nlm.nih.gov
- Huang K, Giddins G, Wu LD. Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis. Am J Sports Med. 2019. PMID: 31821010. pubmed.ncbi.nlm.nih.gov
- Placzek R, Drescher W, Deuretzbacher G, Hempfing A, Meiss AL. Treatment of chronic radial epicondylitis with botulinum toxin A. A double-blind, placebo-controlled, randomized multicenter study. J Bone Joint Surg Am 2007; 89: 255-60. www.ncbi.nlm.nih.gov
- Ciccotti MG, Ramani MN. Medial epicondylitis. Tech Hand Up Extrem Surg 2003; 7(4): 190-6. www.ncbi.nlm.nih.gov
- Gambito ED, Gonzalez-Suarez CB, Oquiñena TI, et al. Evidence on the effectiveness of topical nitroglycerin in the treatment of tendinopathies: a systematic review and meta-analysis. Arch Phys Med Rehabil 2010; 91(8): 1291-305. www.ncbi.nlm.nih.gov
- Olaussen M, Holmedal O, Lindbaek M, Brage S, Solvang H. Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review. BMJ Open 2013; 3: e003564. doi:10.1136/bmjopen-2013-003564 DOI
- Gaujoux-Viala C, Dougados M, Gossec L. Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials. Ann Rheum Dis 2009; 68: 1843-9. PubMed
- Coombes BK, Bisset L, Brooks P et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA 2013; 309: 461-9. pmid:23385272 PubMed
- Smidt N, Assendelft WJJ, van der Windt DAWM, et al. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain 2002; 96: 23-40. PubMed
- Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006; 333: 939. British Medical Journal
- Moradi A, Pasdar P, Mehrad-Majd H, et al. Clinical Outcomes of Open versus Arthroscopic Surgery for Lateral Epicondylitis, Evidence from a Systematic Review. Arch Bone Jt Surg 2019; 7(2): 91-104. www.ncbi.nlm.nih.gov
- Lino Witte, Dr. med., Arzt in Weiterbildung Allgemeinmedizin, Münster