Microtenotomy Using a Radiofrequency Probe to Treat Lateral Epicondylitis

Purpose: To evaluate the safety and effectiveness of microtenotomy using a radiofrequency (RF) probe to treat chronic tendinosis of the common extensor tendon origins of the elbow (lateral epicondyle). Type of Study: Prospective, nonrandomized consecutive case series. Methods: The average age of the 13 patients was 48.3 ± 5.5 years. Before receiving the microtenotomy, all patients had tendinosis symptoms for 6 months or longer and had failed conservative treatment. The RF-based microdebridement was performed on the symptomatic tendon using the TOPAZ Microdebrider device (ArthroCare, Sunnyvale, CA). Patients were followed-up at regular postoperative intervals for 24 months. Pain status was documented using a visual analog scale self-reported measure. Functional outcome was assessed using the upper limb DASH evaluation and grip-strength measures. Quality of life assessment was evaluated using the SF-36 questionnaire. Magnetic resonance imaging was performed at regular intervals over the follow-up period. Results: Patients reported significantly reduced pain from baseline at the 7- to 10-day postoperative examination (P ≤ .01). Pain reduction was statistically stable from 7 to 10 days through the 24-month postoperative period (P ≤ .01). Limb-specific functional outcomes and quality of life scores were improved over baseline values. There were no perioperative or postoperative complications related to the procedure. Conclusions: The RF-based microtenotomy procedure was safe and effective through at least 2 years. This procedure provides a valuable addition for treating patients with lateral epicondylitis associated with tendinosis who have failed conservative therapy. Level of Evidence: Level IV.