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Surgery for lateral elbow pain.

Rachelle Buchbinder1, Renea V Johnston, Les Barnsley

  • 1Monash Department of Clinical Epidemiology at Cabrini Hospital, Department of Epidemiology and Preventive Medicine, Monash University, Suite 41, Cabrini Medical Centre, 183 Wattletree Road, Malvern, Victoria, Australia, 3144.

The Cochrane Database of Systematic Reviews
|March 18, 2011
PubMed
Summary
This summary is machine-generated.

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Surgery for persistent lateral elbow pain lacks sufficient evidence due to small, biased studies. More research is needed to determine the effectiveness of surgical interventions for tennis elbow.

Area of Science:

  • Orthopedic Surgery
  • Pain Management

Background:

  • Persistent lateral elbow pain often necessitates surgical intervention when conservative treatments fail.
  • Tennis elbow (lateral epicondylitis) is a common condition affecting the elbow joint.

Purpose of the Study:

  • To evaluate the benefits and safety of surgical treatments for lateral elbow pain.
  • To synthesize evidence from randomized controlled trials comparing surgical and non-surgical interventions.

Main Methods:

  • A systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science) was conducted up to December 2010.
  • Included randomized and controlled clinical trials in adults with lateral elbow pain, comparing surgical interventions to no treatment or other interventions.
  • Data extraction and risk of bias assessment were performed independently by two authors.

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Main Results:

  • Five trials with 191 participants were included, all with high susceptibility to bias.
  • Comparisons included open extensor carpi radialis brevis (ECRB) surgery, radiofrequency microtenotomy, posterior interosseous nerve decompression, percutaneous release, botulinum toxin injection, and extracorporeal shock wave therapy (ESWT).
  • Insufficient data for meta-analysis due to heterogeneity; some trials showed no significant differences, while others suggested potential benefits for specific procedures like radiofrequency microtenotomy or ESWT for nighttime pain.

Conclusions:

  • The current evidence is insufficient to support or refute the effectiveness of surgery for lateral elbow pain.
  • Heterogeneity in interventions, small sample sizes, and poor outcome reporting limit the conclusions.
  • Further high-quality randomized controlled trials with standardized outcome measures are required to guide treatment decisions.