Surgical treatment of epicondylitis is still a topic of discussion mainly with regard to timing and type of therapy and to long-term results. Many surgical techniques have been suggested (and used by us, too), such as: tendon scarification, possibly in association with bone drilling, epicondylar muscle detachment and sensory deafferentation. Nevertheless, these techniques show some limits: general or peripheral anaesthesia, invasive approach, post-operative immobilisation (requiring rehabilitation), and a long time for recovery (2 months in our experience) with a delay in working activities.

For more than a year we have been using radiofrequency treatment: in day-surgery, with minimally invasive technique and local anaesthesia in case of failure of non-surgical and/or infiltrative treatments. Patients were selected after differential diagnosis with other diseases (fibromyalgia, polymyalgia rheumatica, and thoracic outlet syndrome). Even if our follow-up is quite short, the results of the evaluation of the 54 treated patients show: immediate disappearance of pain, fast functional recovery, return to working activities after 3 weeks, no short-term recurrence and absence of complications.

We report our 4 years’ experience using of demineralized human bone matrix (DBM) in the treatment of complex pathology characterised by bone loss or less regenerating ability, such as congenital or secondary bone mal-union, osteomyelitis, aseptic prosthetic failure, complex bone loss fractures, etc.

Considering the known limitations of autologous transplants (limited quantity, infections and fractures of donor sites, operative and bleeding time increase, abdominal herniations, etc.), we have searched in the literature for alternative materials that would be as similar to the osteoconduction and osteoinduction ability of autologous transplant as possible, respecting bio- and immunocompatiblity.

Since May 2000 we have used DBM in 50 cases: the first 15 patients with mixed technique (DBM and autologous transplant) and then the other 35 only with DBM. We have controlled each patient clinically and by X-ray: average follow up 34 months.

With the same type of pathology and operative technique we have observed a similar recovery with both techniques (DBM with or without autologous transplant); in addition, in patients treated with rigid osteo-synthesis or in patients with osteoporosis we have noted early bone regeneration and no complications with respect to rejection or to osteolysis at the surgical site. In our opinion, this confirms the good osteoconduction and osteoinduction ability of DBM.