Fasciotomy and Surgical Tenotomy for Recalcitrant Lateral Elbow Tendinopathy

Koh, Joyce S.B.; Mohan, Ponnusamy; Howe, Tet Sen; Lee, Brian P.; Chia, Shi‐Lu; Yang, Zixian; Morrey, B.F.

doi:10.1177/0363546512470625

Cited by 80 publications

(40 citation statements)

References 27 publications

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“…In recent years, a novel technique termed as ultrasoundguided percutaneous tenotomy (UGPT) has been reported as a safe and effective procedure for the treatment of LE, with durable improvements in terms of symptoms, function, and ultrasound imaging at 1-year follow-up [98]. Barnes et al [99] reported similar outcomes for 19 patients with chronic, refractory lateral, or medial elbow tendinopathy up to 1 year after the procedure.…”

Section: Percutaneous Surgerymentioning

confidence: 99%

Management of Lateral Epicondylitis: A Narrative Literature Review

Wang

2020

Pain Research and Management

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Lateral epicondylitis, also termed as “tennis elbow,” is the most common cause of elbow pain and dysfunction, mainly resulting from repetitive gripping or wrist extension during various activities. The exact pathogenesis remains largely elusive with putative tendinosis, a symptomatic degenerative process of the local tendon. It is usually diagnosed by clinical examinations. Sometimes, additional imaging is required for a specific differential diagnosis. Although most cases can be self-healing, the optimal treatment strategy for chronic lateral epicondylitis remains controversial. This article presents a landscape of emerging evidence on lateral epicondylitis and focuses on the pathogenesis, diagnosis, and management, shedding light on the understandings and treatment for healthcare professionals.

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Section: Percutaneous Surgerymentioning

confidence: 99%

Management of Lateral Epicondylitis: A Narrative Literature Review

Wang

2020

Pain Research and Management

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“…Using ultrasonic energy, this minimally-invasive procedure is able to debride pathologic tissue through a needle-like device placed within the tendon. In a case series of 20 patients with recalcitrant lateral epicondylitis, percutaneous ultrasonic microtenotomy demonstrated improvement in pain and function in 95% of patients treated at one year 58 . A follow-up on the same patient population demonstrated sustained clinical efficacy at three years, with all patients demonstrating a reduction in tendon thickness and 95% exhibiting a resolution of tendon hypervascularity 59 .…”

Section: Operative Management Of Tendinopathymentioning

confidence: 98%

Pathogenesis and management of tendinopathies in sports medicine

et al. 2018

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Tendinopathy is a major clinical problem in sports medicine and is often difficult to treat. Traditional therapeutic approaches have focused on reducing inflammation, yet research suggests that little to no inflammation is present in the tendons that fail to heal. The purpose of this review was to evaluate the effectiveness of the available treatment options for tendinopathy and to inform best clinical practices. A comprehensive search of electronic databases (PubMed, Google Scholar, and Web of Science) was conducted to identify relevant studies through June 2016. Studies were deemed relevant if they were published in English and contained original research on the management of tendinopathy in humans. Studies varied in methodological quality and were often limited by small sample size and lack of sufficient control groups. Critical evaluation of the literature suggests that physical therapy with or without eccentric exercise should be considered a first-line treatment. Corticosteroids and non-steroidal anti-inflammatory drugs provide short-term symptomatic relief, but long-term efficacy has not been demonstrated. Inconsistent results do not support the routine use of prolotherapy, platelet-rich plasma injections, and topical nitric oxide patches. Operative intervention should be reserved until conservative measures fail or an obvious operative lesion is present. While numerous therapeutic modalities exist for tendinopathy in the athlete, the ideal treatment protocol has not been clearly defined. The development of new targeted therapies for tendinopathy is likely to follow a greater understanding of the cellular and molecular mechanisms that underlie its pathogenesis.

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“…Platelet-rich plasma and other autologous blood preparations have shown promise and are currently one of the hottest topics in tendon care. Percutaneous fasciotomy and tenotomy using ultrasonic energy (FAST procedure) is an interesting technique that has recently shown significant improvements in VAS, DASH scores, and morphological characteristics of tendon quality [2]. For all of these procedures, an increase in the use of ultrasound imaging to guide injection placement has the potential to increase our effectiveness.…”

Section: How Do We Get There?mentioning

confidence: 99%

CORR Insights®: Does Nonsurgical Treatment Improve Longitudinal Outcomes of Lateral Epicondylitis Over No Treatment? A Meta-analysis

Alberta

2015

Clinical Orthopaedics &Amp; Related Research

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Fasciotomy and Surgical Tenotomy for Recalcitrant Lateral Elbow Tendinopathy

Cited by 80 publications

References 27 publications

Management of Lateral Epicondylitis: A Narrative Literature Review

Management of Lateral Epicondylitis: A Narrative Literature Review

Pathogenesis and management of tendinopathies in sports medicine

CORR Insights®: Does Nonsurgical Treatment Improve Longitudinal Outcomes of Lateral Epicondylitis Over No Treatment? A Meta-analysis

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