Abstract. Background. Lateral and medial epicondylitis, more commonly known as Tennis and Golfer's elbow, can cause chronic pain and significant functional impairment in working-age patients. For patients with refractory epicondylitis, platelet rich plasma (PRP) of which ACP is a type, is commonly used as an alternative to surgical intervention, but its efficacy is unproven. Objective. To assess the mid-term outcomes of ultrasound guided ACP injections for patients with refractory epicondylitis who have failed conventional conservative treatment. Methods. 77 patients who were treated with PRP for refractory epicondylitis were included in the study. The mean age of patients was 50.3 years (range 36–70), with 30% men and 70% women. The Oxford Elbow Score (OES) and progression to surgery were used to assess the mid-term outcomes. Results. The mean follow up duration was 2.1 years (range 1.0 – 4.2). Post-procedure OES was recorded for thirty-three patients, of these, thirty-one patients (94.0%) demonstrated an improvement in their OES at mid-term follow-up compared to their pre-op score. The mean change in OES was +16 (range −7 to +34), 81.8% exhibited a minimally important change (MIC) in OES of greater than 8.2 points. Of all seventy-seven patients, seventeen (22.1%) underwent open release and twenty-seven (35.1%) patients were lost to follow up. Conclusion. Ultrasound guided ACP injections can be an effective treatment for refractory epicondylitis and is likely to prevent the need for surgery. Declaration of Interest. (b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project

Failure of conservative treatment for tennis elbow is an indication for surgical decompression. The Topaz® technique utilises radiofrequency to decompress(detension) the tendon and in addition, it is thought to stimulate angiogenesis thereby facilitating healing. Initially we reviewed the three month follow up of 25 tennis elbow decompressions performed using the Topaz® technique. The case notes were reviewed and findings recorded on a structured proforma. After a minimum of 1 year we re-reviewed the case notes to identify recurrences or patients requiring revision surgery. The majority of patients were aged between 35–50 years. 87% of patients had symptoms for more than 12 months and symptoms experienced were mainly pain (100%). All patients had a full trial of physiotherapy and had minimum of two steroid injections. At three month follow up symptoms were completely relieved or improved in 88%. All patients were given an open appointment to review if symptoms recurred. On review of the notes after a minimum of one year, 84% had no further clinic attendances. Four elbows re-attended with symptom recurrence, two underwent traditional open release and two declined revision surgery. In the two patients who declined further surgery, symptoms had resolved at one year. The results of the Topaz® technique are comparable to that of the results of the traditional release from the literature both in terms of success and problems. It would be important to compare it to the traditional release to gauge its benefits against the standard practice