{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T08:44:28Z","timestamp":1781945068057,"version":"3.54.5"},"reference-count":59,"publisher":"BMJ","issue":"6","funder":[{"name":"Institut de recherche Robert-Sauv\u00e9 en sant\u00e9 et s\u00e9curit\u00e9 du travail"},{"name":"Fonds de Recherche du Qu\u00e9bec \u2013 Sant\u00e9"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,19]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic lateral epicondylosis (CLE) of the elbow is a prevalent condition among middle-aged people with no consensus on optimal care management but for which surgery is generally accepted as a second intention treatment. Among conservative treatment options, ultrasound (US)-guided fenestration has shown encouraging results that should be explored before surgery is considered. The primary objective of this study is to compare the efficacy of US-guided fenestration with open-release surgery in patients with failure to improve following a minimum 6 months of conservative treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      This study protocol entails a two-arm, single-blinded, randomised, controlled design. Sixty-four eligible patients with clinically confirmed CLE will be assigned to either US-guided fenestration or open-release surgery. Fisher\u2019s exact test will be used to compare the proportion of patients reporting a change of 11\/100 points or more in the\n                      <jats:italic>Patient Rated Tennis Elbow Evaluation<\/jats:italic>\n                      score at 6 months, according to an intention-to-treat analysis. Secondary analyses will compare the two treatment groups in terms of pain and disability, functional limitations at work, pain-free grip strength, medication burden, patients\u2019 global impression of change and level of satisfaction at 6 weeks, 3, 6 and 12 months, using mixed linear models for repeated measures or Fisher\u2019s exact test, as appropriate. Finally, recursive partitioning analyses will investigate US and elastography parameters as predictors of treatment success at 6 and 12 months. This data will contribute to evidence-based treatment guidelines for CLE and explore the value of imaging biomarkers to improve risk stratification plans and assist clinicians.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Research Ethics Board of our institution on 23 March 2016 (REB 15.327). In case of important protocol modifications, a new version of the protocol with appropriate amendments will be submitted to the REB for approval. Study results will be published in peer-reviewed journals and presented at local, national and international conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02710682\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\">NCT02710682<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-021373","type":"journal-article","created":{"date-parts":[[2018,6,9]],"date-time":"2018-06-09T09:45:32Z","timestamp":1528537532000},"page":"e021373","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Ultrasound-guided tendon fenestration versus open-release surgery for the treatment of chronic lateral epicondylosis of the elbow: protocol for a prospective, randomised, single blinded study"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct02710682","registry":"10.18810\/clinical-trials-gov","type":"results"},{"clinical-trial-number":"nct02710682","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Eugen","family":"Lungu","sequence":"first","affiliation":[{"name":"Department of Radiology, Centre Hospitalier de L\u2019Universite de Montreal (CHUM), Montreal, Quebec, Canada"},{"name":"Department of Radiology, Radio-oncology and Nuclear Medicine, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Grondin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre Hospitalier de L\u2019Universite de Montreal (CHUM), Montreal, Quebec, Canada"},{"name":"Department of Surgery, Faculty of Medicine, 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