Percutaneous microtenotomy using a microdebrider coblation wand for the treatment of lateral epicondylitis: A systematic review

Abstract

Background: Lateral epicondylitis is one of the most common causes of elbow pain. Most patients recover with conservative treatments; however, some patients require surgical intervention. There are 3 common procedures offered: open tenotomy, arthroscopic tenotomy, and percutaneous microtenotomy. In comparison, percutaneous microtenotomy has been proven as a less invasive procedure to treat lateral epicondylitis. We reviewed the literature on the safety and efficacy of using a microdebrider coblation wand to treat lateral epicondylitis, and we compared its outcomes to open and arthroscopic tenotomy.Methods: A search was completed through PubMed Central, Google Scholar, EBSCO host, and Embase for studies that performed percutaneous microtenotomy with a microdebrider coblation wand to treat lateral epicondylitis. Studies were then screened to determine if they met inclusion and exclusion criteria and were reviewed for data analysis and potential risks of bias.Results: A total of 27 articles were identified and 9 articles (eight studies) met the inclusion criteria. Small sample sizes in the studies and heterogeneity of the methodology limited the capacity to carry out a meta-analysis. Percutaneous microtenotomy outcomes seem to be favorable for reduced pain, increased grip strength, and improved functional outcomes, which were similar to outcomes reported with the other surgical techniques. There were no major adverse events reported in the studies secondary to the use of the microdebrider coblation wand. Procedure time and return to daily activities were shorter for the microtenotomy group. Conclusion:Percutaneous microtenotomy performed with a microdebrider coblation seems to be an effective treatment for lateral epicondylitis that provides similar outcomes to the surgical techniques with a lower rate of complications.Abbreviations: DASH = disabilities of the arm, shoulder and hand, MEPS = Mayo Elbow Performance Score, MRI = magnetic resonance imaging, NRS = numerical rating scale, PRP = platelet-rich plasma, RCT = randomized controlled trials, VAS = visual analog scale.