The investigator hopes to determine if one of three current standard of care surgeries for lateral epicondylitis (tennis elbow) is more effective than others. The three surgeries are: arthroscopic tenotomy, open tenotomy, and debridement and repair.

Inclusion Criteria:

• 18-65 yrs old
• pain over the lateral epicondyle (via palpitation over the lateral epicondyle, resisted wrist extension, resisted finger extension of the middle finger) for a duration of greater than 6 months prior to enrollment
• conservative treatment has failed and surgical intervention is recommend as standard of care
• ability to give informed consent

Exclusion Criteria:

• had surgery by a physician or specialist within the last 2 years as treatment for lateral epicondylitis
• congenital deformities, tendon ruptures or elbow fractures within the past year
• co-existing elbow diagnosis (i.e. osteoarthritis or instability)
• pregnant women, women trying to get pregnant, or breastfeeding mothers
• under the age of 18 or over 65
• incapable of giving informed consent