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Comparing Surgical and Nonsurgical Outcomes of Tennis Elbow
Sponsor: University of Pittsburgh
Summary
Tennis elbow is a condition that causes pain on the outside of the elbow, typically caused by motions involving straightening of the arm. The goal of this clinical trial is to investigate whether early surgery leads to better outcomes than physical therapy and watchful waiting for tennis elbow (lateral epicondylitis) in adults. This study aims to answer the following questions: * Does earlier surgical intervention improve pain and function more than physical therapy and watchful waiting after one year? * How do symptoms and function compare between the two treatments over two years? * How often do people who start with physical therapy and watchful waiting end up needing surgery? Researchers will compare early surgery to physical therapy and watchful waiting to see which treatment works better. Participants will... * be randomly assigned to have surgery or to try physical therapy and watchful waiting. * have a physical exam and grip strength test at each visit. * answer questionnaires about their elbow pain and function. * attend appointments at the start of the study, and at 6 weeks, 3 months, 6 months, 1 year, and 2 years.
Official title: Nonoperative vs. Surgical Release for Acute-to-Subacute Lateral Epicondylitis: A Prospective Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
200
Start Date
2026-10
Completion Date
2030-09-15
Last Updated
2026-10-21
Healthy Volunteers
No
Conditions
Interventions
Conservative Arm
* Formal physical therapy: eccentric strengthening and stretching program for the wrist extensor musculature, supervised by a licensed physical therapist, for a minimum of 6 weeks * Activity modification counseling: avoidance of repetitive wrist extension, gripping, and forearm rotation activities that reproduce symptoms * Counterforce (lateral epicondyle) bracing during symptomatic activities * NSAIDs or topical anti-inflammatory agents
Surgical
Patients randomized to surgery will undergo operative release and debridement of the common extensor origin within 6 weeks of enrollment. Surgical technique will be at the attending surgeon's discretion and may include open release and debridement of the ECRB, percutaneous release, or arthroscopic release and debridement. Surgical technique will be recorded as a covariate. All surgeries will be performed by fellowship-trained hand and upper extremity surgeons within the Surgery of the Upper Extremity Research (SUPER) Group. Postoperative rehabilitation protocols will follow standard institutional practice and will be recorded.
Locations (1)
UPMC
Pittsburgh, Pennsylvania, United States