Zum Hauptinhalt springen

Epikondylitis

Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:


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 
  1. Watts AC, Robinson P. Epicondylitis. BestPractice, last updated April 2018. bestpractice.bmj.com  
  2. 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  
  3. Young CC. Medial Epicondylitis. Medscape, last updated Jan 24, 2019. emedicine.medscape.com  
  4. Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e.V. (DGOU). Epicondylopathia radialis humeri. S2k, AWMF-Leitlinie Nr. 187-052. Stand 2019. www.awmf.org  
  5. 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  
  6. Hautmann MG, Beyer LP, Süß C et al. Radiotherapy of epicondylitis humeri. Strahlenther Onkol 2019; 195: 343-51. link.springer.com  
  7. 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  
  8. Fedorczyk JM. Tennis elbow: blending basic science with clinical practice. J Hand Ther 2006; 19(2): 146-53. www.ncbi.nlm.nih.gov  
  9. 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  
  10. Owens BD. Lateral Epicondylitis (Tennis Elbow) Surgery. Medscape, last updated April 29, 2019. emedicine.medscape.com  
  11. 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  
  12. 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  
  13. 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  
  14. 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  
  15. 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  
  16. 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  
  17. 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  
  18. 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  
  19. 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  
  20. 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  
  21. 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  
  22. 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  
  23. 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  
  24. Ciccotti MG, Ramani MN. Medial epicondylitis. Tech Hand Up Extrem Surg 2003; 7(4): 190-6. www.ncbi.nlm.nih.gov  
  25. 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  
  26. 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  
  27. 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  
  28. 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  
  29. Smidt N, Assendelft WJJ, van der Windt DAWM, et al. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain 2002; 96: 23-40. PubMed  
  30. 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  
  31. 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