Safety and efficacy of ultrasound-guided percutaneous A1 pulley release using a needle knife: An anatomical study

Qiu, Zuyun; Li, Hui; Shen, Yifeng; Jia, Yan; Sun, Xiaojie; Zhou, Qiaoyin; Li, Shiliang; Zhang, Weiguang

doi:10.3389/fsurg.2022.967400

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…[3] The tip of the needle can be utilized as a blade, or a needle knife-type instrument can also be employed. [10] (Figure 1.A)…”

Section: Percutaneous A1 Pulley Releasementioning

confidence: 99%

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Serious Complications of the Percutaneous A1 Pulley Release: Case Reports and Literature Review

Lee,

Lee

et al. 2023

Arch Plast Surg

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Percutaneous A1 pulley release, which has been increasingly used to treat trigger fingers, has been widely established as a safe and simple procedure. Multiple studies have reported positive results of percutaneous A1 pulley release. In this study, however, we report cases of patients who developed complications after undergoing percutaneous A1 pulley release at local clinics. A total of six patients visited our hospital for infectious complications after percutaneous A1 pulley release. Various sequelae such as damage to normal structures, insufficient procedure, and tissue necrosis were observed during the exploration. A retrospective study was conducted to identify the cause and trend of the observed complications by instruments (HAKI knife or needle) etc. In the HAKI knife group, there was a tendency for damage to normal structures, while in the needle group, an insufficient release or serious soft tissue necrosis was observed. Based on these cases, our findings confirm the existence and characteristics of infectious complications following the percutaneous A1 pulley release. We further identify that the type of instrument used predicts the nature of complications. Thus, reliable and skilled performance of the procedure by experts is essential for safe treatment.

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“…[3] The tip of the needle can be utilized as a blade, or a needle knife-type instrument can also be employed. [10] (Figure 1.A)…”

Section: Percutaneous A1 Pulley Releasementioning

confidence: 99%

“…The bevel of the needle is oriented longitudinally with the tendon, and a longitudinal release of the A1 pulley is performed. 3 The tip of the needle can be utilized as a blade, or a needle knife-type instrument can also be employed 10 ( Fig. 1A ).…”

Section: Introductionmentioning

confidence: 99%

Serious Complications of the Percutaneous A1 Pulley Release: Case Reports and Literature Review

Lee,

Lee

et al. 2023

Arch Plast Surg

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“…Micro-needle knife (MNK) therapy, primarily for soft tissue injuries, operates on the principle of inserting the MNK into the lesion site to perform gentle cutting, peeling, and loosening procedures [ 28 , 29 ]. This approach aims to eliminate muscle fascia adhesions, contractures, and scars, restoring normal biomechanics, alleviating inflammation and pain, and promoting tissue repair [ 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Micro-Needle-Knife Therapy and Acupuncture in Acute Ankle Sprains: A Randomized Controlled Trial

Lu,

Lang,

Liu

et al. 2024

Med Sci Monit

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Background Micro-needle knife (MNK) therapy releases the superficial fascia to alleviate pain and improve joint function in patients with acute ankle sprains (AAS). We aimed to evaluate the efficacy and safety of MNK therapy vs that of acupuncture. Material/Methods This blinded assessor, randomized controlled trial allocated 80 patients with AAS to 2 parallel groups in a 1: 1 ratio. The experimental group received MNK therapy; the control group underwent conventional acupuncture treatment at specified acupoints. Clinical efficacy differences between the 2 groups before (time-point 1 [TP1]) and after treatment (TP2) were evaluated using the visual analogue scale (VAS) and Kofoed ankle score. Safety records and evaluations of adverse events were documented. One-month follow-up after treatment (TP3) was conducted to assess the intervention scheme’s reliability. Results VAS and Kofoed ankle scores significantly improved in both groups. No patients dropped due to adverse events. At TP1, there were no significant differences between the 2 groups in terms of VAS and Kofoed scores ( P >0.05). However, at TP2, efficacy of MNK therapy in releasing the superficial fascia was significantly superior to that of acupuncture treatment ( P <0.001). At TP3, no significant differences in scores existed between the groups ( P >0.05). Conclusions This study demonstrates that 6 sessions of MNK therapy to release the superficial fascia safely and effectively alleviated pain and enhanced ankle joint function in patients with AAS, surpassing the efficacy of conventional acupuncture treatment. Future studies should increase the sample size and introduce additional control groups to further validate the superior clinical efficacy of this intervention.

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“…This allows for accurate identification of the precise location and extent of tendon constriction, enabling targeted and minimally invasive intervention. 4 Compared with open surgery, this technique has shown promising results in terms of decreased invasiveness, reduced postoperative pain, faster recovery, and improved cosmetic outcomes. 5 Despite the growing interest in ultrasound-guided tendon release, there is a need to systematically evaluate the available evidence and compare its efficacy with open surgery.…”

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confidence: 99%

“…Ultrasound imaging is used to visualize the affected tendon and guide the precise release of the constricted sheath. This allows for accurate identification of the precise location and extent of tendon constriction, enabling targeted and minimally invasive intervention 4 . Compared with open surgery, this technique has shown promising results in terms of decreased invasiveness, reduced postoperative pain, faster recovery, and improved cosmetic outcomes 5…”

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confidence: 99%

Efficacy of Ultrasound‐Guided Tendon Release for Trigger Finger Compared With Open Surgery

Amro,

Kashbour,

Shaaban Abdelgalil

et al. 2024

J of Ultrasound Medicine

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BackgroundTrigger finger (also known as stenosing tenosynovitis) is a chronic inflammatory disorder that affects the fingers and causes discomfort and functional impairment. It is estimated to affect 2–3.6% of the population and is more common in manual laborers and individuals engaged in repetitive hand activities. This study comprehensively compares the efficacy of ultrasound‐guided release versus traditional open surgery in treating trigger fingers.MaterialsWe systematically searched PubMed, Scopus, EMBASE, and the Cochrane Library to identify relevant studies. Inclusion criteria were studies evaluating ultrasound‐guided release of trigger finger (grade 2 and higher) compared with open surgical release. A meta‐analysis was performed by Revman software 5.4.1 to assess efficacy, utilizing appropriate statistical methods to address heterogeneity. Primary outcome measures included “Quick Disability of Arm, Shoulder, and Hand” (QDASH) scores, Grip strength, and the Visual Analogue Scale (VAS). Secondary outcome measures included Days of stopping analgesia, full‐digit flexion and extension, days to return to normal activities, pinch strength, Quinnell grading score, and bow strengthening.ResultsOut of the initial pool of 820 studies, five met the inclusion criteria, including 275 patients with 283 trigger digits. The analysis revealed significant differences favoring the ultrasound‐guided release group over the surgical group for improvement in Quick Disability of Arm, Shoulder, and Hand score in the first month (MD −0.48, 95% CI: 0.75 to −0.2, P = .0007, I2 = 20%). The difference was not statistically significant in the 3‐month follow‐up period (MD −2.25, 95% CI: −0.54 to 0.05, P = .1, I2 = 0%). Additionally, there is a significant difference in the days required for return to normal activities in favor of the ultrasound release approach (MD −13.78, 95% CI: −16.68 to 10.89, P = .00001, I2 = 68%). The data displayed heterogeneity, which was resolved through sensitivity analysis that also favored the ultrasound‐guided group. In terms of grip strength, full‐digit flexion and extension, VAS, and days of stopping analgesia no significant differences were observed.ConclusionsUltrasound‐guided release showed advantages over open surgical release, resulting in improved QDASH score and quicker return to normal activities. This offers a minimally invasive, successful alternative to open surgery, reducing associated risks. Further studies with long‐term follow‐up are recommended.

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Safety and efficacy of ultrasound-guided percutaneous A1 pulley release using a needle knife: An anatomical study

Cited by 8 publications

References 12 publications

Serious Complications of the Percutaneous A1 Pulley Release: Case Reports and Literature Review

Serious Complications of the Percutaneous A1 Pulley Release: Case Reports and Literature Review

Comparative Efficacy of Micro-Needle-Knife Therapy and Acupuncture in Acute Ankle Sprains: A Randomized Controlled Trial

Efficacy of Ultrasound‐Guided Tendon Release for Trigger Finger Compared With Open Surgery

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