scholarly journals Treatment Outcome of Tennis Elbow by Percutaneous Needle Tenotomy

2013 ◽  
Vol 11 (2) ◽  
pp. 32-35
Author(s):  
Nirab Kayatha ◽  
Amit Joshi ◽  
Pankaj Chand ◽  
Bishnu Babu Thapa ◽  
Sushil Rana ◽  
...  
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Visual Analogue Score ◽  
Daily Practice ◽  
Hypodermic Needle ◽  
Painful Condition ◽  
Excellent Outcome ◽  
The Mean ◽  
Pain At Rest

Introduction: Tennis elbow (TE), or lateral epicondylitis of the humerus, is a painful condition seen commonly in the daily practice of Orthopaedic surgeons. One of the myriad of treatment methods for TE is percutaneous needle tenotomy of the common extensor origin. It is a simple operation with minimal morbidity and good-to-excellent results in most of the patients. The aim of this study was to evaluate the outcome in patients with chronic TE. Methods: this was a prospective study in 33 consecutive patients of both sexes with TE who were above 30 years of age. An 18 Gauge hypodermic needle was used under local anaesthesia to percutaneously tenotomise the extensor origin at the point of maximum tenderness. Visual analogue score (VAS) was used to assess the pain prior to intervention and in subsequent follow-ups at first, third, sixth and 12th weeks. Persistence of pain and return to activities of the patients was used to evaluate outcome as excellent, good, fair or poor. Results: At the end of 12 weeks, eleven out of 30 elbows (36.7%) had an excellent outcome, 13 (43.3%) had good, 5 (16.7%) had fair and 1 patient (3.3%) had poor outcome. At first week follow-up, the mean pain at rest was 4.60, the same at night was 2.73 and activity pain was a mean of 7.70 (max-9, min-5). By 12 week follow-up, the mean VAS scores at rest, night and activites were 0.87, 0.63 and 1.53 respectively, showing significant decrease in pain. Conclusions:Percutaneous tenotomy is a simple, safe, patient friendly, effective and easily reproducible method of treating tennis elbow.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/32-35 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7907

Ten- to 14-Year Follow-up of the Nirschl Surgical Technique for Lateral Epicondylitis

2007 ◽  
Vol 36 (2) ◽  
pp. 261-266 ◽  
Author(s):  
Jonathan H. Dunn ◽  
John J. Kim ◽  
Lonnie Davis ◽  
Robert P. Nirschl
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Scoring Systems ◽  
Intensity Scale ◽  
The Mean ◽  
Mini Open

Background Good to excellent short-term results have been reported for the surgical treatment of lateral epicondylitis using various surgical techniques. Hypothesis Surgical treatment for lateral epicondylitis using the mini-open Nirschl surgical technique will lead to durable results at long-term follow-up. Study Design Case series; Level of evidence, 4. Methods Records from 139 consecutive surgical procedures (130 patients) for lateral epicondylitis performed by 1 surgeon between 1991 and 1994 were retrospectively reviewed. Eighty-three patients (92 elbows) were available by telephone for a mean follow-up of 12.6 years (range, 10–14 years). Outcome measures included the Numeric Pain Intensity Scale, Nirschl and Verhaar tennis elbow–specific scoring systems, and American Shoulder and Elbow Surgeons elbow form. Preoperative data were collected retrospectively. Results The mean age of the study group was 46 years (range, 23–70 years) with 45 men and 38 women. Eighty-seven of the procedures were primary, and 5 were revision tennis elbow surgeries. Concomitant procedures were performed in 30 patients including ulnar nerve release in 24 patients, medial tennis elbow procedures in 23 patients, shoulder arthroscopy in 2 patients, carpal tunnel release in 1 patient, and triceps debridement and osteophyte excision in 1 patient. The mean duration of preoperative symptoms was 2.2 years (range, 2 months to 10 years). The mean Nirschl tennis elbow score improved from 23.0 to 71.0, and the mean American Shoulder and Elbow Surgeons score improved from 34.3 to 87.7 at a minimum of 10-year follow-up ( P < .05). The Numeric Pain Intensity Scale pain score improved from 8.4 preoperatively to 2.1 ( P < .05). Results were rated as excellent in 71 elbows, good in 6 elbows, fair in 9 elbows, and poor in 6 elbows by the Nirschl tennis elbow score. By the criteria of Verhaar et al, the results were excellent in 45 elbows, good in 32 elbows, fair in 8 elbows, and poor in 7 elbows. Eighty-four percent good to excellent results were achieved using both scoring systems. Ninety-two percent of the patients reported normal elbow range of motion. The overall improvement rate was 97%. Patient satisfaction averaged 8.9 of 10. Ninety-three percent of those available at a minimum of 10-year follow-up reported returning to their sports. Conclusion The mini-open Nirschl surgical technique with accurate resection of the tendinosis tissue remains highly successful in the long term.

scholarly journals A Single Blind Randomised Clinical Study Of Outcome Of Local Injection Of Platelet Rich Plasma Vs Methyl Prednisolone Acetate In Management Of Lateral Epicondylitis

2020 ◽  
Vol 11 (3) ◽  
pp. 4949-4955
Author(s):  
Kumar Shubham ◽  
Kulkarni P N ◽  
Kshirsagar A Y
Keyword(s):  
Diabetes Mellitus ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Prednisolone Acetate ◽  
Methyl Prednisolone ◽  
Group A ◽  
The Mean ◽  
Group B

The most well-known abuse condition is identified with inordinate wrist expansion and generally alluded to as tennis elbow, however it is in reality increasingly regular in non-tennis players. METHODS- A prospective, comparative study was conducted with 50 patients after Ethical approval. Quantitative data is presented with Mean and Standard deviation. Examination among the investigation bunches is finished with the assistance of unpaired t test according to consequences of ordinariness test. Majority of the patients (80%) in Group A and (76%) in Group B were from the age group of 31-40 years. The mean age in Group A was 36.4±5.44 years and in Group B were 36.8±5.87 years. Majority of the patients in both groups were female. There was dominance of right side (68% and 72%) as compared to left side (32% and 28%) in both groups. The mean duration of symptom in Group A was 2.24±0.72 months as compared to 1.92±0.81 months in Group B. 20% and 12% patients in Group A had Diabetes Mellitus and Hypertension respectively whereas 16% and 24% patients in Group B had Diabetes Mellitus and Hypertension respectively. The mean baseline VAS score in Group A was 7.6±0.51 and Group B was 7.7±0.38 which decreased to 5.1±0.81. The mean baseline MGS score in Group A was 74.6±10.32 which increased to 91.6±4.08 in 2 weeks. And in Group B was 74.5±10.31 which increased to 99.8±2.646 in 2 weeks. The MGS score improved more in Group B after 2 weeks (p=0.005), 4 weeks (p=0.002) and 6 weeks (p=0.022). However, toward the finish of 3 months, a half year and a year, improvement in MGS Score was fundamentally better in Group A as compared to Group B.Along these lines, we presumed that PRP as an unrivaled treatment choice in instances of tennis elbow. In any case, keeping in see the constrained time of follow up in the current examination we prescribe longer follow up studies to additionally unite our discoveries and set up the long haul viability of PRP in instances of sidelong epicondylitis.

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis

2020 ◽  
Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Short Term ◽  
Shockwave Therapy ◽  
Other Substances ◽  
Injured Tendon ◽  
Satisfaction Rates

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

scholarly journals Percutaneous Tennis Elbow Release Under Local Anaesthesia

2012 ◽  
Vol 6 (1) ◽  
pp. 129-132 ◽  
Author(s):  
MA Nazar ◽  
S Lipscombe ◽  
S Morapudi ◽  
G Tuvo ◽  
R Kebrle ◽  
...  
Keyword(s):  
Local Anaesthesia ◽  
Tennis Elbow ◽  
Long Term Results ◽  
Dash Score ◽  
Day Case ◽  
Horse Riding ◽  
Minimal Scarring ◽  
Percutaneous Release ◽  
The Mean

Introduction: When the non-operative treatment of tennis elbow fails to improve the symptoms a surgical procedure can be performed. Many different techniques are available. The percutaneous release of the common extensor origin was first presented by Loose at a meeting in 1962. Despite the simplicity of the operation and its effectiveness in relieving pain with minimal scarring this procedure is still not widely accepted. This study presents the long-term results of percutaneous tennis elbow release in patients when conservative measures including local steroid injections have failed to relieve the symptoms. Patients and Methods: Percutaneous release of the extensor origin was performed in 24 consecutive patients (seven male and seventeen female), providing 30 elbows for this study. The age of the patients ranged from 26 to 71 years with mean age of 55 years. The technique involved a day case procedure in the operating theatre using local anaesthesia without the need for a tourniquet. The lateral elbow was infiltrated with 5mls 1% lignocaine and 5mls 0.5% bupivicaine with 1:200,000 adrenaline. All operations were performed by the senior author. The patients were assessed post operatively by using DASH (disabilities of arm, shoulder and hand) score and Oxford elbow scores. The mean follow up period was 36 months (1-71months). Results: Twenty one patients returned the DASH and Oxford elbow questionnaires. Four patients were lost in the follow up. The post operative outcome was good to excellent in most patients. Eighty seven percent of patients had complete pain relief. The mean post-op DASH score was 8.47 (range 0 to 42.9) and the mean Oxford elbow score was 42.8 (range 16 to 48). There were no complications reported. All the patients returned to their normal jobs, hobbies such as gardening, horse riding and playing musical instruments. Conclusion: In our experience Percutaneous release of the epicondylar muscles for humeral epicondylitis has a high rate of success, is relatively simple to perform, is done as a day case procedure and has been without complications. Percutaneous release is a viable treatment option after failed conservative management of tennis elbow.

scholarly journals Comparison between prolozone therapy and extracorporeal shockwave therapy in management of pain and function in resistant cases of lateral epicondylitis: a randomised controlled trial

2020 ◽  
Vol 7 (8) ◽  
pp. 1216
Author(s):  
Margaret Chabungbam ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh ◽  
Yumnam Ningthemba ◽  
Sreejith C. ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Tennis Elbow ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Painful Condition ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Vas Score ◽  
Randomised Controlled

Background: Lateral epicondylitis also known as the tennis elbow is a painful condition of the elbow caused by overuse. The disease imparts significant disability to those affected in terms of the quantity and quality of work done.Methods: A randomised controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal for a period of 1 year from February 2017 to January 2018. Eighty-four patients with resistant lateral epicondylitis recruited were divided into 2 groups- group A received Prolozone injection while group B underwent Extracorporeal Shockwave Therapy (ESWT).Results: Assessments of VAS (Visual Analog Scale) and PRTEE (Patient Rated Tennis Elbow Evaluation) were done at 8 weeks and 24 weeks. The mean VAS score in Prolozone group improved from 7.22±0.89 to 4.04±1.01 at 8 weeks to 1.67±0.70 at end of 24 weeks. In ESWT group, mean VAS score improved to 3.91±0.72 at 8 weeks and reduced to 2.3±0.68 at end of 24 weeks. PRTEE improved significantly in both the groups, from 85.33±3.29 to 24.87±2.10 in Prolozone group, and from 85.17±2.83 to 41.89±3.17 in ESWT group.Conclusions: The improvement in pain and disability is better in prolozone group than ESWT (p<0.05) in chronic lateral epicondylitis.

scholarly journals Cannulated Cancellous Screw Fixation for Capitellum Fractures in Adolescents

2011 ◽  
Vol 19 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Kee Leong Ong ◽  
Arjandas Mahadev
Keyword(s):  
Performance Index ◽  
Kirschner Wire ◽  
Excellent Outcome ◽  
Excellent Functional Outcome ◽  
Cancellous Screws ◽  
The Mean ◽  
And Function ◽  
Anterior Direction

Purpose. To review the outcome of 9 adolescents treated with 2 to 3 cannulated cancellous screws for type-1 capitellum fractures. Methods. Records of 8 boys and one girl aged 12 to 14 (mean, 14) years with type-1 capitellum fractures were reviewed. The mechanism of injury was a fall on the flexed elbow. No patient had associated injuries or neurovascular compromise. In 2 patients, the fracture was minimally displaced and treated with a cast. The remaining 7 patients with displaced fractures underwent open reduction and internal fixation using 4.0-mm cannulated partially threaded cancellous screws inserted in a posterior-to-anterior direction. In one patient, a Kirschner wire was added to fix a small comminuted fragment. Elbow pain, range of motion, stability, and function were evaluated using the Mayo Elbow Performance Index. Results. The mean follow-up period was 7 (range, 2–18) months. The mean Mayo Elbow Performance Index score was 100, indicating excellent outcome. No patient developed avascular necrosis or heterotrophic ossification. All patients achieved anatomic bone union. All implants were removed after a mean of 4.7 (range, 2–7) months. Conclusion. The fixation of type-1 capitellum fractures with 2 to 3 cannulated cancellous screws inserted posteroanteriorly achieved excellent functional outcome.

scholarly journals Outcomes and Return to Sport After Ulnar Collateral Ligament Reconstruction in Adolescent Baseball Players

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876932 ◽  
Author(s):  
Michael Saper ◽  
Joseph Shung ◽  
Stephanie Pearce ◽  
Viviana Bompadre ◽  
James R. Andrews
Keyword(s):  
Case Series ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Duration Of Symptoms ◽  
Excellent Outcome ◽  
Patient Reported ◽  
The Mean

Background: The number of ulnar collateral ligament (UCL) reconstructions in adolescent athletes has increased over the past 2 decades. Clinical results in this population have not been well studied. Purpose/Hypothesis: The purpose of this study was to evaluate the outcomes and return to sport after UCL reconstruction in a large group of adolescent baseball players. We hypothesized that excellent clinical outcomes and high rates of return to sport would be observed in this population at a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: We reviewed 140 adolescent (aged ≤19 years) baseball players who underwent UCL reconstruction with the American Sports Medicine Institute (ASMI) technique by a single surgeon. Medical records were reviewed for patient demographics, injury characteristics, operative details, and surgical complications. Patient-reported outcomes were assessed using the Conway scale, the Andrews-Timmerman (A-T) score, the Kerlan-Jobe Orthopaedic Clinic (KJOC) score, and a 0- to 100-point subjective scale for elbow function and satisfaction. Return to sporting activity was assessed using a custom-designed questionnaire. Results: The mean age at the time of surgery was 18.0 years (range, 13-19 years), and the mean follow-up was 57.9 months (range, 32.4-115.4 months). Over half (60%) of patients were high school athletes. The mean duration of symptoms before surgery was 6.9 months (range, 0.5-60.0 months). Partial tears were identified in 57.9% of patients, and 41.3% of patients had preoperative ulnar nerve symptoms. Graft type included the ipsilateral palmaris in 77.1% of patients. Concomitant procedures were performed in 25% of patients. Outcomes on the Conway scale were “excellent” in 86.4% of patients. The mean A-T and KJOC scores were 97.3 ± 6.1 and 85.2 ± 14.6, respectively. Mean patient satisfaction was 94.4. Overall, 97.8% of patients reported returning to sport at a mean of 11.6 months (range, 5-24 months), and 89.9% of patients returned to sport at the same level of competition or higher. A total of 11.6% of patients went on to play professional baseball. Conclusion: UCL reconstruction with the ASMI technique is an effective surgical option in adolescents, with excellent outcome scores. At a minimum of 2-year follow-up, nearly 90% of patients returned to their preinjury level of sport.

Total subaxial reconstruction

2010 ◽  
Vol 13 (4) ◽  
pp. 424-434 ◽  
Author(s):  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Visual Analog Scale ◽  
Anterior Decompression ◽  
Analog Scale ◽  
Excellent Outcome ◽  
Arm Pain ◽  
Subaxial Cervical Spine ◽  
Pain Scores ◽  
The Mean

Object Certain cervical spinal conditions require decompression and reconstruction of the entire subaxial cervical spine. There are limited data concerning the clinical details and outcomes of patients treated in this manner. The object of this study was to describe the specific technique employed to perform a total subaxial reconstruction and review the postoperative outcomes following surgery. Methods The author performed a review of data prospectively collected in 27 consecutive patients undergoing complete anterior decompression and reconstruction of the anterior cervical spine and followed by posterior instrumented arthrodesis with or without decompression. Results There were 16 men and 11 women whose mean age was 59 years (range 35–86 years). The minimum follow-up was 12 months and the mean follow-up period for all patients was 26 months. One patient underwent C2–7 surgery, and in all others the procedure crossed the cervicothoracic junction. Following surgery patients remained intubated for an average of 3.3 days (range 1–22 days). The mean hospital length of stay was 11 days (range 3–45 days). One patient died 6 weeks following an uneventful surgery. Pneumonia developed in 5 patients, 1 patient experienced a minor pulmonary embolism, and 2 patients had posterior wound infections. No patient was neurologically worse following surgery. A single patient presented with a C-8 radiculopathy 6 weeks after surgery. At final follow-up no patient complained of dysphagia when specifically questioned about this potential problem. In all patients solid fusions developed at each treated levels. Preoperatively the mean sagittal Cobb angle was 15.4° (kyphosis) and the postoperative mean angle was −10.9° (lordosis) representing a total average correction of over 25° (p < 0.0001). The mean preoperative Neck Disability Index was 27.6; this score decreased to 15.5 (p = 0.0008) postoperatively. The mean pre- and postoperative visual analog scale neck pain scores were 6.0 and 2.1, respectively (p = 0.0004), and mean visual analog scale arm pain scores decreased by 3.7 following surgery (p = 0.001). Based on Odom criteria, the author found that 8 patients had an excellent outcome and 14 patients a good outcome. There were 4 patients in whom the outcome was judged to be fair and the single death was recorded as a poor outcome. The mean preoperative Nurick score was 2.68. Postoperatively the group improved to an average score of 1.5; the difference between the 2 was statistically significant (p = 0.002). Conclusions Segmental anterior decompression and reconstruction of the entire subaxial cervical spine, combined with an instrumented posterolateral fusion, can be performed with acceptable morbidity and is of significant benefit in selected patients.

A Comparison of Two Treatment Regimens for Lateral Epicondylitis: A Randomized Trial of Clinical Interventions

1997 ◽  
Vol 6 (3) ◽  
pp. 226-234 ◽  
Author(s):  
Wendy I. Drechsler ◽  
John F. Knarr ◽  
Lynn Snyder-Mackler
Keyword(s):  
Physical Therapy ◽  
Radial Head ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Controlled Clinical Trial ◽  
Treatment Regimens ◽  
Strengthening Exercises ◽  
Positive Results

Eighteen subjects participated in a randomized controlled clinical trial to compare the effectiveness of two physical therapy treatments for tennis elbow. The subjects were divided into two groups: In the neural tension group (NTG), the head of the radius was mobilized and specific physical therapy mobilizations were used to address hypomobility of the radial nerve. The standard treatment group (STG) received ultrasound, transverse friction massage, and stretching and strengthening exercises for the extensors of the wrist. All subjects were treated twice weekly for 6 to 8 weeks. Follow-up data were obtained at 3 months post-treatment. Subjects who received radial head mobilization improved over time (p <.05), while those who did not receive radial head mobilization did not improve. Results of the NTG treatment were linked to the radial head treatment, and isolated effects of the NTG treatment could not be determined. There were no long-term positive results in the STG.

scholarly journals Functional outcome of platelet rich plasma on lateral epicondylitis of elbow

2017 ◽  
Vol 3 (3) ◽  
pp. 408
Author(s):  
Narayanan V. L. ◽  
Preetha P. ◽  
Maria Joshna J. ◽  
Mishal Dhivya P. J. ◽  
Anbu Selvan
Keyword(s):  
Plasma Treatment ◽  
Conservative Management ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Mayo Score ◽  
Plasma Injection ◽  
Before And After ◽  
Elbow Function ◽  
The Mean

<p class="abstract"><strong>Background:</strong> The study was conducted with the aim to explore the efficacy of platelet rich plasma in sixty patients who presented to us with lateral epicondylitis of elbow where conservative management has failed<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Between 2013 and 2015, 60 patients (M: F- 20: 40) with lateral epicondylitis of elbow were included. All patients presented to us with lateral epicondylitis of elbow where conservative management has failed. All patients are treated with platelet rich plasma injection. Serial follow-up were done at 1, 6 and 12 month.<strong></strong></p><p class="abstract"><strong>Results:</strong> All sixty patients had significant improvement before and after platelet rich plasma injection. The mean VAS score and the Mayo score suggests significant improvement in pain and elbow function following platelet rich plasma treatment<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Platelet rich plasma improves pain and elbow function in patients suffering from lateral epicondylitis where conservative management has failed. Platelet rich plasma treatment may decrease the overall time for healing, and thereby decreasing the overall need for surgical intervention<span lang="EN-IN">.</span></p>

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