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BESS patient care pathway: Tennis elbow
Harvinder Pal Singh1, Adam C Watts2
1University Hospitals of Leicester NHS Trust, Leicester, UK.
Shoulder & Elbow
|August 4, 2023
Summary
This guidance summary offers evidence-based recommendations for managing lateral elbow tendinopathy (LET). It uses the GRADE system to assess literature quality and the strength of evidence for various treatments.
Area of Science:
- Orthopaedics
- Evidence-Based Medicine
Background:
- Lateral elbow tendinopathy (LET), commonly known as tennis elbow, affects numerous individuals, necessitating clear management guidelines.
- Current treatment options for LET vary, with a need for synthesized evidence to guide clinical practice.
Purpose of the Study:
- To provide a guidance summary for the management of lateral elbow tendinopathy (LET).
- To rate the quality of literature and grade the strength of available evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
Main Methods:
- A multidisciplinary guideline development group was assembled, including orthopaedic surgeons, physiotherapists, and patients.
- PICO questions were formulated to assess the clinical effectiveness of LET treatments compared to placebo or no treatment.
- A systematic literature search (January 2011 – April 2022) identified relevant systematic reviews and randomized controlled trials.
- Evidence quality was assessed using GRADE criteria, including study design, risk of bias, and magnitude of effect.
Main Results:
- Recommendations for LET management were categorized as strong or weak based on evidence quality and the balance of benefits and harms.
- The summary provides a clear overview of the quality of evidence supporting different management strategies for LET.
Conclusions:
- This summary offers a comprehensive assessment of the evidence base for lateral elbow tendinopathy management.
- Clinicians can utilize this information to make informed decisions regarding patient treatment, supported by graded recommendations.
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