Lateral tennis elbow: "Is there any science out there?"

Area of Science:

• Orthopaedic Surgery
• Sports Medicine
• Elbow Biomechanics

Background:

• Lateral epicondylitis, commonly known as tennis elbow, is prevalent among orthopaedic conditions.
• Existing literature reveals a lack of scientific rigor in both nonoperative and operative treatment studies.
• The term 'epicondylitis' implies inflammation, yet pathological examinations often show no inflammatory evidence.

Purpose of the Study:

• To critically examine the prevailing myths and misconceptions surrounding tennis elbow.
• To review the scientific rationale, or lack thereof, for current nonoperative and operative treatment modalities.
• To clarify the pathoetiology and biomechanics of lateral epicondylitis based on available evidence.

Main Methods:

• Comprehensive literature review of studies on tennis elbow diagnosis, pathology, and treatment.
• Analysis of the quality of published trials, focusing on study design, patient selection, and statistical power.
• Examination of anatomical and biomechanical factors contributing to lateral elbow pain.

Main Results:

• Most nonoperative treatments for tennis elbow are unproven, costly, and time-consuming.
• Published surgical studies often lack objective data, relying on case series with inherent bias.
• There is a significant paucity of high-quality, peer-reviewed research to guide clinical decision-making.

Conclusions:

• The current understanding and management of tennis elbow are based on weak evidence and subjective experience.
• A clearer picture of the condition's pathoetiology and the scientific basis of treatments is needed.
• Further high-quality research is essential to establish evidence-based guidelines for tennis elbow management.