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Various surgical techniques\u2014including open and arthroscopic debridement, percutaneous tenotomy, and tendon repair\u2014have been described; however, the optimal surgical strategy remains controversial. This review summarizes current evidence regarding surgical techniques and clinical outcomes, with particular emphasis on the role of tendon repair in patients with high-grade common extensor tendon tears. Overall, surgical treatment yields satisfactory outcomes, with success rates exceeding 80%\u201390%. Increasing evidence suggests that the severity of tendon tearing plays an important role in surgical decision-making. In particular, tears involving \u226550% of tendon thickness appear to represent a clinically meaningful threshold for considering tendon repair rather than debridement alone.<\/jats:p>","DOI":"10.5397\/cise.2026.00388","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:59:40Z","timestamp":1778572780000},"page":"264-271","update-policy":"https:\/\/doi.org\/10.5397\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of recalcitrant lateral epicondylitis: indications, techniques, and outcomes"],"prefix":"10.5397","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6384-1438","authenticated-orcid":true,"given":"Tae-Yeong","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3262-2161","authenticated-orcid":true,"given":"Bong 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