Resistant tennis elbow: shock-wave therapy versus percutaneous tenotomy

Fifty-six patients who suffered from chronic persistent tennis elbow of more than six months duration were randomly assigned to two active treatment groups. Group 1 (n = 29) received high-energy extracorporeal shock wave treatment (ESWT; 1,500 shocks) at 18 kV (0.22 mJ/mm²) without local anaesthesia; group 2 (n = 27) underwent percutaneous tenotomy of the common extensor origin. Both groups achieved improvement from the base line at three weeks, six weeks, 12 weeks and 12 months post-intervention. The success rate (Roles and Maudsley score: excellent and good) at three months in the ESWT group was 65.5% and in the tenotomy group was 74.1%. ESWT appeared to be a useful noninvasive treatment method that reduced the necessity for surgical procedures.