Authors' objectives: To determine whether there is any evidence to support the efficacy and/or effectiveness of the following two treatment modalities for (refractory) lateral epicondylitis (LE): (1) Barbotage and (2) ultrasonic tenotomy (Tenex procedure).

Authors' results and conclusions: There were 11 studies that were retrieved in full for this systematic review. Two expert review studies identified from search No.1 did not provide any data on the role of barbotage in treating LE. As such, we conclude, that at present, there is no published study reporting on the efficacy and/or effectiveness of barbotage in treating LE. At present, there is some evidence presenting the effectiveness of ultrasonic tenotomy (Tenex procedure) in treating LE. However, this evidence of effectiveness must be interpreted with caution due to the fact that potential selection bias (mainly in the form of unclear patient selection), potential outcome measurement errors (associated with the retrospective data collection) and the unclear effect of potential confounders (such as age, sex, occupation etc. in affecting observed outcomes). Also, the unclear effect of co-interventions cannot be ruled out while the potential effect of chance, in the form of unadjusted multiple comparisons may also be a potential issue. Further, the majority of these studies were in the form of case series without any controls for comparing relative effectiveness to different treatment modalities; as well, the only study that employed controls compared the Tenex procedure with a potentially non-effective treatment modality.

Authors' methods: A comprehensive and systematic literature search was conducted on commercial medical literature databases on May 24, 2022. No limitations, such as the date or language of publication, were implemented in any of these searches. A manual search was also conducted on the references of the articles that were retrieved in full, as well as within the Evidence-Based Practice Group article collection for anything related to the LE treatment modalities.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2022

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/lateral-epicondylitis-barbotage-ultrasonic-tenotomy?lang=en

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC