Surgical approaches to treating tennis elbow may not offer additional benefit to patients, as discussed in research presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day in San Diego. The study, a randomized, double-blinded clinical trial, explored patient responses to a common surgery aimed at repairing a damaged elbow, compared to a placebo procedure.
The study analyzed 13 patients who underwent surgery to remove a degenerated portion of their extensor capri radialis brevis (ECRB), compared to a group of 13 who received an incision over their lateral elbow and no further repair. Patients included had experienced symptoms of tennis elbow for more than 6 months, and attempted at least two non-surgical treatment approaches such as physical therapy, massage, acupuncture, or splinting/bracing, but had no symptom relief over that period.
"Our data shows both groups experienced significant improvements in pain measures by 26 weeks after surgery, including frequency of pain with activity," commented lead author Martin Kroslak, MBBS, MSpMed, MSurg, from the Orthopaedic Research Institute in Sydney, Australia. "Further, these results were consistent or improved after 1-4 years of follow-up, with no significant difference between the two groups at any point."
Patients were required to complete questionnaires, indicating symptoms including pain frequency and severity with activity and rest, during sleep, and also difficulty picking up objects or twisting motions. Frequency of elbow pain during activity was the primary outcomes measure for each group. Both groups were treated with the same rehab, including ice application, stretching, and strengthening rehab program within 2 weeks of surgery. At 2.5 year follow-up 22 patients completed a questionnaire and 11 returned for exam.
"Managing chronic tennis elbow is a challenge for a large portion of the active population," noted Kroslak. "Our research demonstrates the challenges in outlining a treatment plan for these patients, and the continued work to be done in developing both surgical and non-operative approaches."