Recalcitrant Lateral Epicondylitis: A Systematic Review on Current Nonoperative and Operative Treatment Modalities.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Lateral epicondylitis, or tennis elbow, is a frequent cause of elbow pain.
• Persistent symptoms often resist conservative treatments, lacking a clear consensus on optimal management.
• Recalcitrant lateral epicondylitis (RLE) necessitates evaluation of advanced therapeutic options.

Purpose of the Study:

• To systematically review and synthesize literature on nonoperative and operative treatments for RLE.
• To provide insights into the efficacy of various treatment modalities for refractory lateral epicondylitis.
• To inform clinical decision-making for persistent elbow pain.

Main Methods:

• Systematic review adhering to PRISMA 2020 guidelines.
• Comprehensive database search (PubMed, MEDLINE/Ovid, CINAHL, Cochrane, Scopus).
• Inclusion of studies evaluating treatment options for RLE.

Main Results:

• 27 studies involving 1,958 patients were analyzed.
• Treatments included platelet-rich plasma injections, percutaneous tenotomies, and surgical procedures (arthroscopic and open).
• Diverse interventions were evaluated for efficacy.

Conclusions:

• Multiple treatment modalities demonstrate promising short-, medium-, and long-term efficacy for RLE.
• A comprehensive, patient-centered strategy integrating evidence-based care is crucial.
• Effective management of refractory lateral epicondylitis requires a tailored approach.