title: Arthroscopic Treatment of Lateral Epicondylitis: Tenotomy Versus Debridement.
abstract: OBJECTIVE
  To compare the outcome of 2 arthroscopic techniques for treating recalcitrant lateral epicondylitis.
  
  
  METHODS
  The study included patients undergoing arthroscopic treatment of lateral epicondylitis during 2 different time periods: April 2005 to October 2007 (tenotomy) and May 2009 to June 2010 (debridement). By using a patient-administered form, baseline information including QuickDASH (disabilities of the arm, shoulder and hand) score (primary outcome), visual analog scale (VAS) of pain, and VAS of function was recorded prospectively. To have the same follow-up period of minimum 4 years in the 2 groups, the follow-up was conducted at 2 different points of time.
  
  
  RESULTS
  Of a total of 326 patients fulfilling the requirements for inclusion in the study, 283 patients (87%) were followed up (144 male and 139 female, median age 46 [21 to 65] years), 204 (87%) in the tenotomy group and 79 (88%) in the debridement group. In both groups, a significant improvement in the QuickDASH was found at the follow-up compared with baseline: from 60 to 12 in the debridement group (P < .001) and from 59 to 13 in the tenotomy group (P < .001). No statistically significant difference was found in baseline or follow-up QuickDASH, VAS of pain, VAS of function, or failure (reoperation) rate between the 2 groups. The mean length of sick leave was 2 weeks shorter in the debridement only group (P = .007).
  
  
  CONCLUSIONS
  Both arthroscopic methods lead to a significant improvement of pain and function, and no statistically significant difference was found in any outcome parameters between the 2 techniques at this minimum 4-year evaluation. The results indicate that tenotomy of the extensor carpi radialis brevis may be an unnecessary step in the arthroscopic treatment of lateral epicondylitis Debridement only is a potentially less costly procedure, and the current finding of a mean 2 weeks shorter sick leave in the debridement only group proposes a substantial cost saving in a societal perspective.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Teres Bergen, Bergen, Norway; Department of Orthopaedic Surgery, Deaconess University Hospital, Haraldsplass, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: eirik.solheim@uib.no.
authors.forename: Eirik
authors.initials: E
authors.lastname: Solheim
authors.affiliation: Department of Orthopaedic Surgery, Teres Bergen, Bergen, Norway.
authors.forename: Janne
authors.initials: J
authors.lastname: Hegna
authors.affiliation: National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway.
authors.forename: Jannike
authors.initials: J
authors.lastname: Øyen
authors.affiliation: Department of Orthopaedic Surgery, Deaconess University Hospital, Haraldsplass, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Eivind
authors.initials: E
authors.lastname: Inderhaug
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013716:Tennis Elbow / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult