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Published on: October 10, 2020
Surgery for tennis elbow: a systematic review.
Marcus Bateman1, Chris Littlewood2, Beth Rawson3
1Orthopaedic Department, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK.
Surgery for tennis elbow (lateral epicondylitis) shows no superior effectiveness compared to non-surgical options. Current evidence is limited by poor study quality, necessitating high-quality trials for tennis elbow treatment guidance.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Evidence-Based Medicine
Background:
- Tennis elbow treatment lacks consensus, with rising surgical rates in the USA unsupported by robust research.
- This systematic review addresses the need for an updated, balanced perspective on randomized controlled trials for tennis elbow.
Purpose of the Study:
- To systematically review published randomized controlled trials (RCTs) on tennis elbow treatments.
- To provide an evidence-based update on the efficacy of surgical versus non-surgical interventions for tennis elbow.
Main Methods:
- Comprehensive electronic and hand searches of multiple databases (MEDLINE, EMBASE, Cochrane Library, etc.).
- Risk of bias assessment using the Cochrane Risk of Bias Tool.
- Narrative synthesis of data due to heterogeneity, based on evidence levels.
Main Results:
- Twelve studies of poor methodological quality were included in the review.
- Surgical interventions for tennis elbow were found to be no more effective than non-surgical and sham interventions.
- Modified surgical techniques may offer benefits but lack placebo-controlled validation.
Conclusions:
- Current evidence suggests surgery is not more effective than conservative treatment for tennis elbow, despite methodological limitations.
- High-quality, placebo-controlled surgical trials with conservative arms are needed to guide clinical practice for recalcitrant cases.
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