PERCUTANEOUS RELEASE VERSUS OPEN SURGICAL FOR THE TREATMENT OF TENNIS ELBOW. A PATIENT BASED SATISFACTION OUTCOME COMPARATIVE STUDY.

Abstract

Objective: The main objective of our study was to compare the outcome and complications between open and percutaneous tennis elbow release using the Total Elbow Scoring System (TESS). Our null hypothesis is that there is no difference in patient based outcome measures and morbidity between both groups.

Methods: We evaluated a cohort of 40 patients (41 elbows) with clinical evidence of tennis elbow that had surgery after failed conservative treatment. All patients were followed up for a minimum of 12 months and information entered into a structured questionnaire. Other outcomes measures assessed include; Visual Analogue Score (VAS), length of time to return to work, and wound complications.

Results: Seventeen (17) and Twenty-four (24) elbows were managed by percutaneous release and open surgery respectively. There were twenty-one female patients (22 elbows) and nineteen male patients (19 elbows). The mean age of the study population was 45years (s.d.: 8.4yrs). The mean duration of symptoms before surgery was 20 months (s.d.: 9.1mths). All 17 elbows that had percutaneous release procedures had a TESS score greater than 80, in comparison to 19 out of 24 elbows with open procedures, although this was not quite significant. (p=0.06). A score of between 80 and 100 is considered good or excellent. Patients that had open surgery had a significantly higher pain (Visual analogue score) VAS in comparison to closed procedures (p=0.01).

A significantly higher proportion of patients that had percutaneous procedures were able to return to work within 2 weeks in comparison to open procedures (p-=0.03). There were 4 cases of wound complication that occurred only in patients with open surgery.

Conclusion: We conclude that percutaneous release for tennis elbow can produce satisfactory outcomes, with lower morbidity and earlier return to work compared with open procedures.