Orthotic devices for tennis elbow.
BACKGROUND
Lateral epicondylitis (tennis elbow) is a frequently reported condition. A wide variety of treatment strategies has been described. As of yet, no optimal strategy has been identified.


OBJECTIVE
The objective of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow.


METHODS
An electronic database search was conducted using Medline, Embase, Cinahl, the Cochrane Controlled Trial Register, Current Contents and reference lists from all retrieved articles. Experts on the subjects were approached for additional trials.


METHODS
All randomised clinical trials (RCT) describing individuals with diagnosed lateral epicondylitis and comparing the use of an orthotic device as a treatment strategy were evaluated for inclusion.


METHODS
Two reviewers independently assessed the validity of the included trials and extracted data on relevant outcome measures. Dichotomous outcomes were expressed as Relative Risks (RRs) and continuous outcomes as Standardised Mean Differences (SMD), both with corresponding 95% confidence intervals (95% CI). Statistical pooling and subgroup analyses were intended


RESULTS
Five small-size RCTs (N per group 7-49) were included. Validity score ranged from 3-9 positive items out of 11. Subgroup analyses were not performed due to the small number of trials. The limited number of included trials present few outcome measures and limited long-term results. Pooling was not possible due to large heterogeneity amongst trials.


CONCLUSIONS
No definitive conclusions can be drawn concerning effectiveness of orthotic devices for lateral epicondylitis. More well-designed and well-conducted RCTs of sufficient power are warranted.
Struijs
P A
PA
Orthopaedic Surgery, G4-259, Academic Medical Centre, Meibergdreef 9, Postbus 22660, Amsterdam, Netherlands, 1100 DD. p.a.struys@amc.uva.nl
Smidt
N
N
Arola
H
H
van Dijk
C N
CN
Buchbinder
R
R
Assendelft
W J
WJ
D006801:Humans; D009989:Orthotic Devices; D016032:Randomized Controlled Trials as Topic; D013716:Tennis Elbow / Q000628:therapy*