The use of radiofrequency ablation for the treatment of lateral epicondylitis: a systematic review of the literature.

BACKGROUND

Lateral epicondylitis (LE) is a degenerative overuse angio-fibroblastic dysplasia caused by eccentric overload at the origin of the extensor carpi radialis brevis tendon. This systematic review aimed to evaluate the effectiveness of radiofrequency ablation for managing LE.

METHODS

This systematic review was registered with PROSPERO under the ID CRD420251165456. A comprehensive literature search was conducted in the NHS Knowledge and Library Hub and PubMed. Eleven studies met the inclusion criteria, including fair-to-good-quality case series and four randomized controlled trials (RCTs) with low risk of bias. Risk of bias was assessed using validated tools appropriate to each study design, and results were synthesized using various statistical methods.

RESULTS

Three hundred and eleven elbows were treated with radiofrequency (RF) ablation. The majority have improved pain following these procedures, and no serious adverse events were reported. Overall, the evidence suggests that RF is a viable minimally invasive alternative for chronic LE, yielding significant pain relief and functional improvement with quick recovery and low risk. In comparative trials, its outcomes are on par with those of open or arthroscopic surgery, while offering shorter operative time and potentially a quicker return to work/activities.

CONCLUSIONS

RF represents a reasonable surgical alternative for patients who fail conservative therapy, particularly those seeking rapid recovery. However, claims of definitive superiority over other surgical techniques are not supported by available evidence. Future research should include sham-controlled or active-comparator RCTs with standardized outcome measures and long-term follow-up (≥2 years).