Botulinum toxin injection versus surgical treatment for tennis elbow: a randomized pilot study

Surgical treatment is considered the last option for chronic tennis elbow. The purpose of this pilot study was to compare treatment with botulinum toxin infiltration of the wrist extensor, a less invasive method, with a surgical wrist extensor release (Hohmann operation). Forty patients were included in the prospective randomized study; one group of patients had surgery (n = 20), the other group of patients was treated with botulinum toxin (n = 20). The results of evaluations after 3, 6, 12, and 24 months are presented. One year after treatment 13 (65%) patients in the botulinum toxin group and 15 (75%) patients in the operative group had good to excellent results. Two years after treatment 15 patients in the botulinum toxin group (75%) had good to excellent results; four patients had been operated on after initial treatment with botulinum toxin Type A. Seventeen patients in the operative group scored good to excellent (85%) at 2 years. When analyzed with an overall scoring system, no differences were found between the two forms of treatment. Botulinum toxin infiltration, a less invasive technique, may be an alternative for surgical treatment of tennis elbow.