Outcome of Percutaneous Release of Tennis Elbow: A Non-Randomized Controlled Trial Study

Abstract

BackgroundTennis elbow is a common disorder of the upper extremity. It can be treated conservatively in the majority of patients, but some resistant cases eventually can be treated by percutaneous release with good functional outcome.Materials and methodsThis non-randomized control trial was conducted at the Department of Orthopaedics Surgery in a tertiary care hospital from July 2015 to June 2016 on 50 patients who underwent percutaneous release of the common extensor origin using an 18 gauge hypodermic needle. These patients did not respond to conservative treatment including rest, nonsteroidal anti-inflammatory drugs (NSAIDS) and local steroid injections. The outcome was graded as Excellent, Good, Fair, and Poor.ResultsFifty patients (50 elbows) were included in the study. Thirty-two patients were female (64%), and 18 were male (36%). The right side was affected in 37 patients (74%) and left side in 13 (26%). The time taken to achieve a completely pain-free elbow ranged from one day to two months (average of 26.2 days). Those who did not achieve a pain-free elbow had a residual pain of 1.5 to six on the visual analogue scale (VAS) (average 2.32). Excellent outcome was noticed in 24 patients (48%); Good result in eight patients (36% ); Fair in four patients (eight percent) and Poor in four patients (eight percent).ConclusionTennis elbow probably results from the degenerative tear of the common extensor origin, and a percutaneous tenotomy using an 18 gauge hypodermic needle is a simple, safe, patient-friendly, efficient, and easily reproducible method of treating tennis elbow in those who are resistant to conservative treatment, and it can be done as an outpatient procedure.

Reliability and usefulness of YouTube as a source of informative media for arthroscopic tennis elbow surgery: A systematic review of the published videos

“…[ 26 ] Surgical management is considered the treatment of choice in this particular cohort of patients. Several surgical techniques like the open release of ECRB,[ 27 ] Nirschl’s procedures,[ 28 ] percutaneous tenotomies,[ 29 ] and even micro-ablation[ 30 ] have been tried. Arthroscopic treatment in such recalcitrant cases has shown to be comparable to open surgical procedures in terms of functional outcomes.…”

Outcome analysis of percutaneous tenotomy in chronic lateral epicondylitis elbow

“…Literature review mentions a variety of treatment options for tennis elbow which range from conservative therapy to operative treatment. 1 Surgical intervention can lead to early recovery and return to daily life activities. Extensor tenotomy with various variations has been used by various authors in recent past reporting good to excellent outcomes.…”

“…Pathology of condition is unclear, with a variety of conditions being used to explain its aetiology. 1 Most likely, a combination of mechanical overloading and abnormal microvascular changes in the extensor tendon origin esp. extensor carpi radialis brevis are known to contribute to pathology of this condition.…”

Arthroscopic Management of Tennis elbow

“…Most studies have not showed any complications. 22 In a study on 18 patients operated using this maneuver, 14 did not show any complications, but this author's histological analysis reported microscopic findings of residual tendinopathy in ten cases had one case who presented paresthesia in the forearm for 14 days after the surgery, with spontaneous improvement. In our study, we found a complication rate of 5% (one case with local alterations of sensitivity in the region of the lateral portal).…”