gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Mini-operative treatment of tennis elbow using bipolar radio-frequency

Meeting Abstract

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  • presenting/speaker Dawid Mrozik - Handproject Clinic, Swissmed Private Hospital, Gdansk, Poland
  • Agnieszka Jackiewicz - Handproject Clinic, Swissmed Private Hospital, Gdansk, Poland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-712

doi: 10.3205/19ifssh1225, urn:nbn:de:0183-19ifssh12259

Published: February 6, 2020

© 2020 Mrozik et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.