Tennis elbow, also known as extensor tendonitis, is most commonly seen in sports enthusiasts and dominant hand laborers. It is more common in tennis and table tennis players and chefs. As a result of repetitive overload, small tears occur in the tendon tissue at the attachment of the extensor tendon of the humeral epicondyle, the limb is not braked or rested, and the biomechanical properties of the tendon are reduced beyond its physiological repair capacity, becoming a chronic injury process. The chronic, repetitive, and cumulative strain of tennis elbow has a significant impact on daily work and life. In particular, resistance movements such as fist clenching, wrist flexion and towel wringing can trigger or aggravate the symptoms. Sometimes the pain can be involved in the forearm, and the object is suddenly lost when it is held. On examination, the forearm muscles are atrophied, and pressure pain is evident in the external epicondyle of the humerus at the elbow joint, and pain is induced by resistance tests at the wrist joint. Collagen is an important structure of tendon tissue, accounting for 90% of the dry weight of the tendon, and has the function of conducting load and maintaining mechanical stability. In normal tendons, the collagen fibrous network between the fibroblasts and the vascular structures is arranged in an orderly manner, but when the arrangement is disturbed after injury, the ratio of collagen subtypes in the tendon is relatively disturbed. Therefore, it has been suggested that the disease is associated with collagen degradation and cellular hyperplasia that may contribute to the reduced mechanical properties of the tendon. Tendon degeneration with collagen disintegration could theoretically explain the pain mechanism . For many years, the disease was considered to be an aseptic inflammatory disease of the tendon, hence the name tendonitis. In fact, it is not an inflammatory lesion and is the result of chronic tendon strain. Alfredson and Lorebtzon found that the local pathology following tendon strain was not inflammatory cells but rather a disturbance in the ultrastructural arrangement of collagen fibers, disruption of fiber continuity, and proliferation of blood vessels and fibroblasts. Ahmed suggested that poor local blood supply is another factor in the development of this disease, as ischemia causes malnutrition of tendon cells and difficulty in synthesizing and repairing the extracellular matrix that rebuilds the tendon. Recent studies have found that in cases of chronic tendon strain pain, neurotransmitter concentrations and lactate concentrations are significantly higher than in normal tendons, suggesting that “P” substances and chondroitin sulfate also play a role in tendon pain after tendon strain ischemia. In conclusion, the pathogenesis of tennis elbow is being further explored and no definitive conclusion has been made yet. Traditionally, tennis elbow has been treated with physical therapy, non-steroidal anti-inflammatory drugs, local closed injections of corticosteroids, sports modifications, brace protection and extracorporeal shock waves. In patients where conservative treatment has not been effective, surgical local release has been used to promote the growth of new capillaries and to initiate and promote a healing response. The use of the plasma knife is a new concept, and the advantages of radiofrequency ablation under arthroscopic surveillance are that the endoscopic procedure is less invasive and avoids the disturbance and destruction of peritendinous tissues by open surgery, preventing postoperative adhesions and scar formation. After the procedure, the patient’s pain was relieved and the grip strength test was significantly improved. The pain point of the lateral epicondyle of the humerus was marked before the operation, and the pain point of the lateral epicondyle of the humerus was marked with 0.5% lidocaine 20 ml for local anesthesia. 5 mm was incised at the pain point of the lateral epicondyle of the humerus, and a 20 mm space was separated along the subcutaneous tissue and the extensor muscle group. The painful point of the humeral epicondyle is stabbed vertically at the painful point, and the number of treatment points is determined by the size of the lesion at 3 mm intervals. Bipolar radiofrequency technology is fundamentally different from traditional electrocoagulation and thermotherapy. The electric field generated by the plasma knife’s energy-producing electrodes creates a thin vaporization layer that breaks down the gas to form a plasma zone, a layer of conductive gas containing free electrons, ions, neutral chemical groups and other neutral substances. The particles in the plasma region are very energetic and can break most of the chemical bonds that connect soft tissue molecules. It is also a highly reactive medium in which water molecules can be broken down into activated H groups. Ablation is a novel application of bipolar radiofrequency energy that produces a small area of high energy plasma at the tip of the ablation electrode, which breaks down molecular bonds in the tissue. Several studies have shown an increase in neovascularization and angiogenic markers after ablation of the tendon, showing a rapid and effective healing response, thus explaining the significant efficacy of combined ablation over conventional approaches to the treatment of tennis elbow. Recent histological studies have shown that, despite minimal surgical trauma, the procedure is sufficient to initiate a “healing” response, as evidenced by a significant increase in VEGF and α-V-integrin levels. It is possible that this stimulates cellular activity, initiates the cellular proliferation system, stimulates vascular growth and assists in the regulation of numerous growth factors Restores tendon blood flow, improves tendon nutrition, accelerates the healing response, and creates a favorable internal environment for healing. The improvement of blood supply is an important factor in healing, as local microvascular production and increased local perfusion facilitate the removal of acidic products and pain-causing substances and promote the healing and repair process. In conclusion, the mechanism of action of bipolar radiofrequency (RF) in the treatment of tennis elbow is not well understood and is still being explored.