Annular Ligament Instability

Abstract

Purpose: Lateral elbow pain is frequently attributed to epicondylalgia; yet, less common pathologies with limited literature representation exist. This study aims to delineate the diagnostic significance of alterations in the biomechanics and morphology of the annular ligament as a distinctive factor in lateral elbow pain. Methods: A retrospective observational analysis was conducted on patients surgically treated for lateral elbow pain with arthroscopic assistance from January 2015 to December 2018. Initial preoperative diagnoses primarily indicated epicondylalgia. Results: The study encompassed 82 patients (48 men, 34 women; mean age: 44.6 ± 5.3 years), with 91.46% involved in demanding manual work. Notably, 17 patients underwent surgery due to recurrent symptoms. Arthroscopic assessments revealed diverse morphological and biomechanical variations in annular ligaments, designating 36 patients with an identified incompetent annular ligament. Conclusions: Our arthroscopic study on lateral epicondylalgia cases involved a comprehensive analysis of annular ligament anatomy and radiocapitellar joint biomechanics. The formulated anatomic classification, incorporating crucial variables such as radial head coverage and ligament tension, unveiled implications for joint instability. Recognition of simultaneous pathologies, notably annular ligament lesions, signifies a potential, yet unexplored, avenue for differential diagnosis in cases of lateral elbow pain.