TENNIS ELBOW: A PROSPECTIVE RANDOMISED CONTROLLED TRIAL: COMPARISON OF OPEN PERCUTANEOUS RELEASE

Abstract

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 1 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 ANOVA were performed.

The groups were similar in respect of demographic and pre-test variables. Statistical analyses using Mann-Whitney showed significant differences for patient satisfaction (p=0.012), time to return to work (p=0.0001), improvements in DASH Score (p=0.002) and improvement in sporting activities (p=0.046). There was a trend to improvement in work related activity. Repeated measures ANOVA comparing the pre-operative data for each group were also significant for standardized DASH scores (p=0.0082) and sporting activities (p=0.043).

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 3 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.