title: Extensor tendon release in tennis elbow: results and prognostic factors in 80 elbows.
abstract: OBJECTIVE
  The objectives of this study were to evaluate the results in the outpatient treatment of recalcitrant lateral epicondylitis with release of the common extensor origin according to Hohmann and to determine any prognostic factors.
  
  
  METHODS
  Eighty tennis elbows in 77 patients with a characteristic history of activity-related pain at the lateral epicondyle interfering with the activities of daily living refractory to conservative care for at least 6 months and a confirmatory physical examination were included. Clinical outcome was evaluated using the QuickDASH score system. Data were collected before the operation and at the medians of 18 months (range 6-36 months; short term) and 4 years (range 3-6 years; medium term) postoperatively.
  
  
  RESULTS
  The mean QuickDASH was improved both at the short- and the medium-term follow-ups and did not change significantly between the follow-ups. At the final follow-up, the QuickDASH was improved in 78 out of 80 elbows and 81% was rated as excellent or good (QuickDASH<40 points). We found a weak correlation between residual symptoms (a high QuickDASH score) at the final follow-up and high level of baseline symptoms (r=0.388), acute occurrence of symptoms (r=0.362), long duration of symptoms (r=0.276), female gender (r=0.269) and young age (r=0.203), whereas occurrence in dominant arm, a work-related cause or strenuous work did not correlate significantly with the outcome.
  
  
  CONCLUSIONS
  Open lateral extensor release performed as outpatient surgery results in improved clinical outcome at both short- and medium-term follow-ups with few complications. High baseline disability, sudden occurrence of symptoms, long duration of symptoms, female gender and young age were found to be weak predictors of poor outcome.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Bergen Surgical Hospital, and Department of Surgical Sciences, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. eirik.solheim@uib.no
authors.forename: Eirik
authors.initials: E
authors.lastname: Solheim
authors.forename: Janne
authors.initials: J
authors.lastname: Hegna
authors.forename: Jannike
authors.initials: J
authors.lastname: Øyen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013710:Tendons / Q000601:surgery*; D013716:Tennis Elbow / Q000503:physiopathology / Q000601:surgery*; D058971:Tenotomy / Q000379:methods* / Q000534:rehabilitation; D013997:Time Factors; D016896:Treatment Outcome