Outcome Comparison of Open Surgery and Arthroscopic Surgery in Treating Lateral Epicondylitis: A Meta-Analysis

Introduction: Lateral Epicondylitis (LE), or tennis elbow, is a degenerative tendinopathy of the extensor carpi radialis brevis (ECRB) causing lateral elbow pain, most common in adults aged 40–55 years. It results from repetitive wrist extension and forearm supination, leading to overuse and microtears. Diagnosis is clinical, supported by imaging when needed. Surgical treatment is reserved for refractory cases, with open and arthroscopic techniques being the main options. Arthroscopy offers faster recovery and better pain control but may require longer operative time. This meta-analysis compares outcomes of open and arthroscopic surgery for LE, focusing on pain, function, operative duration, and return-to-work time. Methods: This study following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Multiple databases were searched for studies that compared functional outcomes of open surgery versus arthroscopic surgery for lateral epicondylitis with a minimum 12 months follow-up. The outcome investigated were VAS, ROM, Grip Power (kg), Qdash Score, complication rate, and operative time. Result: Six studies were included for the quantitative meta-analysis. The analyses revealed that there were no significant difference in VAS (MD = 0.17; 95% CI, −0.25 to 0.59; p = 0.43) ROM (MD = -0.19; 95% CI, −1.56 to 1.18; p = 0.78), Grip Power (kg) (MD = 1.62; 95% CI, −1.60 to 4.83; p = 0.32), QDash score (MD = 1.27; 95% CI, −0.56 to 3.09; p = 0.17), and complication rate (MD = 0.36; 95% CI, 0.09 to 1.46; p = 0.15) after 12 months follow-up between arthroscopy and control group. Meanwhile, the operative time needed was significantly lower in control group compared to the arthroscopy group (MD = 17.77; 95% CI, 2.03 to 33.50; p = 0.03). Conclusion: This study concluded that there was no significant difference in term of outcome between arthroscopy and open surgery in managing lateral epicondylitis. However, open surgery took a shorter operative time compared to arthroscopy. Keywords: Open Surgery, Arthroscopic, Lateral Epicondylitis, Tennis Elbow.