Lateral epicondylitis: an evaluation of three methods of operative treatment (SS-38)

      Objective: The purpose of this study was to evaluate the clinical results of three surgical methods in treating recalcitrant lateral epicondylitis and compare them to each other. Methods: 316 Patients were treated operatively over a 5 year period for recalcitrant lateral epicondylitis by two surgeons. All patients failed an aggressive course of nonoperative treatment consisting of NSAIDs, bracing, physical therapy, and steroid injections. Of those 316 patients, 76 were treated with percutaneous release performed in the office, 94 patients were treated with arthroscopic release, and 125 patients were treated with open lateral epicondylectomy. The follow-up averaged 2.2 years. Patient outcomes were evaluated with the Andrews Carson rating scale. Additionally patients’ ability to return to previous level of vocation, activities, and the need for additional intervention was noted. Results: Satisfactory results were 93% in the percutaneous group, 95% in the arthroscopic group, and 97% in the open group. There were no significant statistical differences comparing the Andrews Carson scale, participation in vocation and recreational activities postoperatively, and need for further treatment. Conclusions: The most frequent treatment for recalcitrant lateral epicondylitis has been open release; however, percutaneous as well as arthroscopic techniques are equally efficacious treatment options.