Bateman, M, Littlewood, C, Rawson, B and Tambe, AA (2017) Surgery for Tennis Elbow: a Systematic Review. Journal of Shoulder and Elbow Surgery, 11 (1). pp. 35-44.

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Abstract

Background
There is no consensus on the most suitable treatment for tennis elbow but, in the USA, surgical intervention is increasing despite a lack of supportive research evidence. The aim of this systematic review was to provide a balanced update based on all relevant published randomized controlled trials conducted to date.

Methods
An electronic search of MEDLINE, EMBASE, CINAHL, BNI, AMED, PsycINFO, HBE, HMIC, PubMed, TRIP, Dynamed Plus and The Cochrane Library was complemented by hand searching. Risk of bias was assessed using the Cochrane Risk of Bias Tool and data were synthesized narratively, based on levels of evidence, as a result of heterogeneity.

Results
Twelve studies of poor methodological quality were included. The available data suggest that surgical interventions for tennis elbow are no more effective than nonsurgical and sham interventions. Surgical technique modifications may enhance effectiveness compared to traditional methods but have not been tested against a placebo.

Conclusions
Current research evidence suggests that surgery for tennis elbow is no more effective than nonsurgical treatment based on evidence with significant methodological limitations. Given the recalcitrant nature of tennis elbow for some patients, further research in the form of a high-quality placebo-controlled surgical trial with an additional conservative arm is required to usefully inform clinical practice.

Item Type: Article
Additional Information: "This is the peer reviewed version of the following article: Surgery for Tennis Elbow: a Systematic Review, which has been published in final form at http://journals.sagepub.com/doi/abs/10.1177/1758573217745041. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
Uncontrolled Keywords: tennis; elbow; surgery; systematic review
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RD Surgery
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 02 Nov 2017 09:58
Last Modified: 18 Mar 2019 15:17
URI: https://eprints.keele.ac.uk/id/eprint/4169

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