ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
Intra-articular findings in symptomatic minor instability of the lateral elbow (SMILE).
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Effectiveness of extracorporeal shock wave therapy in patients with tennis elbow: A meta-analysis of randomized controlled trials.Medicine · 2020Pooled it
- It's time to change perspective! New diagnostic tools for lateral elbow pain.Musculoskeletal surgery · 2017Trial
- The Use of Flexion Arthrography Computed Tomography Signs (FACTS) to detect minor instability of the lateral aspect of the elbow.JSES reviews, reports, and techniques · 2026Article
- Reliability of magnetic resonance imaging findings in symptomatic minor instability of the lateral elbow: A cross-specialty evaluation.Journal of experimental orthopaedics · 2026Article
- Functional shape of the proximal radioulnar joint: anatomical characterization through Alpha and Beta Angles.JSES reviews, reports, and techniques · 2026Article
- Arthroscopic Lateral Collateral Ligament Reconstruction With Tendon Graft in High-Grade Atraumatic Posterolateral Rotatory Instability in Elbows.Arthroscopy techniques · 2026Article
- Lateral Epicondylitis With Soft Tissue Atrophy Due to Repeated Corticosteroid Injections: Comparison of Open and Arthroscopic Surgery.Orthopaedic journal of sports medicine · 2026Article
- Elbow Microinstability: From the State of the Art to an Integrated Clinical Approach.Journal of clinical medicine · 2025Article
- Clinical Outcomes of Radial Collateral Ligament Repair in Recalcitrant Lateral Epicondylitis with Mild Elbow Instability Following Repeated Steroid Injections.Journal of clinical medicine · 2025Article
- Article
- Arthroscopic Lateral Ulnar Collateral Ligament Plication/Reconstruction With Augmented Lateral Collateral Ligament Imbrication.Arthroscopy techniques · 2025Article
- Anatomical considerations, diagnosis, and treatment of medial and posterolateral elbow rotatory instability in athletes: an arthroscopic perspective and literature review.International orthopaedics · 2025Review
- Joint Position and General Hypermobility Affect Elbow Joint Congruence on Magnetic Resonance Imaging: A Prospective Cohort Study.The American journal of sports medicine · 2025Article
- Ultrasonography of lateral elbow pain through a weighted varus flexion position contributes to detect minor instabilities.JSES international · 2025Article
- Recognition and Differentiation of Baker Lesions in Lateral Epicondylitis During Arthroscopic Debridement.Arthroscopy techniques · 2024Article
- Use of a Mechanical Forearm Holder During Elbow Arthroscopy in Lateral Decubitus Position.Arthroscopy techniques · 2024Article
- A Novel Surgical Treatment Management Algorithm for Elbow Posterolateral Rotatory Instability (PLRI) Based on the Common Extensor Origin Integrity.Journal of clinical medicine · 2024Review
- Semiquantitative index of symptomatic minor instability of the lateral elbow at CT arthrography (SMILE index): clinical applicability and reproducibility study.European radiology · 2024Article
- Don't forget to SMILE-a novel radiological index to characterize symptomatic minor instability of the lateral elbow.European radiology · 2024Article
- Failed surgical treatment for lateral epicondylitis: literature review and treatment considerations for successful outcomes.JSES reviews, reports, and techniques · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLateral epicondylitis is generally considered an extra-articular condition. The role of minor instability in the aetiology of lateral elbow pain has rarely been considered. The aim of this study was to evaluate the correlation of lateral ligamentous laxity with aspects of intra-articular lateral elbow pathology and investigate the role of minor instability in lateral elbow pain.
methodsThirty-five consecutive patients aged between 20 and 60 years with recalcitrant lateral epicondylitis who had failed conservative therapy and had no previous trauma or overt instability, were included. The presence of three signs of lateral ligamentous patholaxity and five intra-articular findings were documented during arthroscopy. The relative incidence of each of these was calculated, and the correlation between patholaxity and intra-articular pathology was evaluated.
resultsAt least one sign of lateral ligamentous laxity was observed in 48.6% of the studied cohort, and 85.7% demonstrated at least one intra-articular abnormal finding. Radial head ballottement was the most common sign of patholaxity (42.9%). Synovitis was the most common intra-articular aspect of pathology (77.1%), followed by lateral capitellar chondropathy (40.0%). A significant correlation was found between the presence of lateral ligamentous patholaxity signs and capitellar chondropathy (p = 0.0409), as well as anteromedial synovitis (p = 0.0408).
conclusionsAlmost one half of patients suffering from recalcitrant lateral epicondylitis display signs of lateral ligamentous patholaxity, and over 85% demonstrate at least one intra-articular abnormality. The most frequent intra-articular findings are synovitis and lateral capitellar chondropathy, which correlate significantly with the presence of lateral ligamentous patholaxity. The fact that several patients demonstrated multiple intra-articular findings in relation to laxity provides support to a sequence of pathologic changes that may result from a symptomatic minor instability of the lateral elbow (SMILE) condition. LEVEL OF EVIDENCE: III.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.