title: Medium-Term Results After Treatment of Recalcitrant Lateral Epicondylitis: A Prospective, Randomized Study Comparing Open Release and Radiofrequency Microtenotomy.
abstract: BACKGROUND
  Recalcitrant lateral epicondylitis (elbow extensor-origin tendinosis) is a common cause of elbow pain with many treatment options. In the present study, the medium-term results after open release and radiofrequency microtenotomy are reported.
  
  
  OBJECTIVE
  Microtenotomy would provide long-term pain relief that was as good as the open release method.
  
  
  METHODS
  Prospective, randomized trial.
  
  
  METHODS
  Twenty-four patients randomized to either open release or microtenotomy were assessed after 5 to 7 years. Clinical examination and dynamic infrared thermography (DIRT) of both elbows were performed preoperatively and at the medium-term follow-up. Magnetic resonance imaging (MRI) of both elbows was performed at the medium-term follow-up.
  
  
  RESULTS
  Significant pain reduction was found using a visual analog scale (VAS) at the medium-term follow-up in both groups compared with the preoperative assessment (P < .005). The Mayo Elbow Performance Score (MEPS) increased significantly in both groups (P < .01). The improvement in grip strength was not significant in either group. There was no significant difference between the groups in terms of VAS, strength, and the MEPS. On the DIRT examinations, there were significantly fewer hot spots at the medium-term follow-up than preoperatively (P = .0067, both study groups together). The MRI examinations revealed grade II changes in the operated elbow in 1 patient in each group at the medium-term follow-up, while all the other MRI examinations revealed a normal tendon.
  
  
  CONCLUSIONS
  In this prospective, randomized trial with a medium-term follow-up, the results were similar after surgical release and microtenotomy in patients with recalcitrant lateral epicondylitis. The hypothesis was thus verified.
authors.affiliation: Department of Orthopedics, University Hospital North Norway, Tromsø, Norway. ; Bone and Joint Research Group, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors.forename: Khaled
authors.initials: K
authors.lastname: Meknas
authors.affiliation: Department of Orthopedics, University Hospital North Norway, Tromsø, Norway.
authors.forename: Thabit N
authors.initials: TN
authors.lastname: Al Hassoni
authors.affiliation: Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Norway.
authors.forename: Åshild
authors.initials: Å
authors.lastname: Odden-Miland
authors.affiliation: Department of Radiology, University Hospital North Norway, Tromsø, Norway.
authors.forename: Miguel
authors.initials: M
authors.lastname: Castillejo
authors.affiliation: Department of Orthopedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden.
authors.forename: Jüri
authors.initials: J
authors.lastname: Kartus
keywords: epicondylitis; infrared thermography; microtenotomy; tendinosis