Artikel
Mini-operative treatment of tennis elbow using bipolar radio-frequency
Suche in Medline nach
Autoren
Veröffentlicht: | 6. Februar 2020 |
---|
Gliederung
Text
Objectives/Interrogation: Lateral epicondylitis or tennis elbow is a noninflammatory, degenerative condition of the origin of the ECRB or EDC, associated with overuse and characterized by: absence of inflammatory cells, profusion of disorganized collagen and fibroblastic hypertrophy, nutritional flow is compromised, making it difficult for tenocytes to synthesize the extracellular matrix necesary for repair and remodelling. A principal aim in treatment of tendinosis is to establish a biologic healing response.
The purpose of this study was to evaluate the long-term results, safety and effectiveness of using RF-based microtenotomy to treat tennis elbow.
Methods: It was prospective, nonrandomized, two-center clinical study. Into the study were involved 49 patients (28 men and 21 women) with symptomatic epicondylitis lateralis (tennis elbow) for at least 6 months and had failed conservative treatment. The average age of patients was 44,9 years (range: 26-57). Dominant limb was involved in 89% of the patients.
As operative method we used bipolar microtenotomy of extensor carpi radialis brevis and/or common extensor tendom using TOPAZ Microdebrider device (ArthroCare, EU). Before operation was done VAS, DASH and clinical examination. Postoperative clinical assessment: 2 and 14 day. Follow-up: 12 and 24 months after oparation: VAS, DASH, USG, clinical examination. USG: LOGIQ e GE Healthcare device with a 7,7-15 Mhz linear transducer.
Results and Conclusions: The dominant arm was involved in 89% with unilateral involvement. There were no perioperative or postoperative complications related to the procedure. The mean VAS decreased from 8,8 before operation to 2,6 (p=0,001). Postoperative DASH value was 21,6. There were found ultrasonography abnormalities 24 months after operation:
- focal hypoechoic area: 36 patients (74%)
- focal anechoic area: 16 patients (33%)
- cortical irregularity of the lateral epicondyle: 34 patients (70%)
- tendon thickening: 13 patients (27%)
- intratendinous calcifications: 11 patients (22%)
- increased vascularity: 9 patients (18%)
- 1.
- RF-based microtenotomy appears to be a safe and effective method for treating patients with chronic tendinosis.
- 2.
- Microtenotomy is a technically simple procedure to perform and is associated with a rapid and uncomplicated recovery. Pain relief was achieved rapidly in all patients and diminished even further with time.
- 3.
- Ultrasonography is a widely and inexpensive imaging study for assessing tendons providing useful information on the severity and stage of tendon pathology.