TENNIS ELBOW: A PROSPECTIVE RANDOMISED CONTROLLED TRIAL – COMPARISON OF OPEN AND PERCUTANEOUS TECHNIQUES

Abstract

Introduction and Aims: To compare the outcome of percutaneous release and fonnal open release for tennis elbow.

Method: We conducted a prospective randomised controlled trial. 45 patients (total of 47 elbows) underwent either a formal open release or a percutaneous tenotomy (24 open, 23 percutaneous). All patients had pre-operative assessment by the DASH (Disability of the Arm, Shoulder and Hand) scoring system. The surgery was performed by one surgeon (BN Muddu). Both groups were followed up for a minimum of 12 months and re-assessed using the DASH scores, time for return to work and patient satisfaction. Statistical analysis using Mann-Whitney and repeated measures ANOV A were performed.

Results: The groups were similar in respect of demographic and pre-test variables. Statistical analyses using Mann-Whitney showed significant differences for patient satisfaction (p=O.OI2), time to return to work (p=O.OOOI), improvements in DASH Score (p=O. OO2) and improvement in sporting activities (p=O. O46). There was a trend to improvement in eight in work related activity. Repeated measures ANOV A comparing the pre-operative data for each group were also significant for standardised DASH scores (p=O. OO82) and sporting activities (p=O.O43).

Conclusion: Our study has shown that there is a significant difference in outcome in the two patient groups. Those patients undergoing a percutaneous release returned to work on average three weeks earlier and their symptoms as shown from their DASH scores improved significantly more than those undergoing an open procedure. The percutaneous procedure is a quicker, simpler procedure to perform than an open procedure. Our study has shown that patients have significantly better outcome measures after a percutaneous procedure.