Outcome analysis of percutaneous tenotomy in chronic lateral epicondylitis elbow of greater than 6 months duration
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20200742Keywords:
Analgesics, Percutaneous tenotomy, Tennis elbowAbstract
Background: Lateral epicondylitis elbow is a self-limiting condition with an unclear pathology. Conservative therapy is treatment of choice in lateral epicondylitis elbow but chronic lateral epicondylitis elbow (>6 month) is a condition difficult to treat. Percutaneous extensor tendon release can be a viable treatment option in such conditions.
Methods: This prospective study was conducted in 2016 to 2017 at the Department of Orthopaedics Surgery in a tertiary care institute. 30 patients were treated by percutaneous tenotomy. The outcome was assessed at follow ups using numerical rating scale (NRS), disabilities of the arm, shoulder, and hand questionnaire (DASH) and Oxford scores.
Results: 30 elbows were included in this study. They were managed by percutaneous method (PT; n=30). The mean age of patients was 41.74 years (range 26-67 years). Females were affected more than males in both groups (3:1). Dominant limb was involved in 86% of patients.73% of females were house wives exposed to household chores and manual activities while 40% of males were manual workers. Mean hospital stay was 35 minutes (range 20-43 minutes). Patients were followed up at 3 month and 6 month post intervention. NRS, DASH, Oxford score assessment showed that all the scores were significantly decreased (p<0.05) at 3 month and 6 month in patients undergoing percutaneous tenotomy.
Conclusions: Lateral epicondylitis >6 month duration is difficult to treat. Percutaneous tenotomy is effective modality of treatment in such conditions.
References
Panthi S, Khatri K, Kharel K, Byanjankar S, Shrestha R, Sharma JR, et al. Outcome of Percutaneous Release of Tennis Elbow: A Non-Randomized Controlled Trial Study. Cureus. 2017;9(1):952.
Chourasia AO, Buhr KA, Rabago DP, Kijowski R, Lee KS, Ryan MP, et al. Relationships between biomechanics, tendon pathology and function in individuals with lateral epicondylosis. J Orthop Sports Phys Ther. 2013;43(6):368-78.
Kumar S, Stanley D, Burke NG, Mullett H. Tennis elbow. Ann R Coll Surg Engl. 2011;93(6):432-6.
Grundberg AB, Dobson JF. Percutaneous release of the common extensor origin for tennis elbow. CORR. 2000;(376):137-40.
Lakhey S, Mansfield M, Pradhan RL, Rijal KP, Paney BP, Manandhar RR. Percutaneous extensor tenotomy for chronic tennis elbow using an 18 G needle. KUMJ. 2007; 5(4):446-8.
Barth J, Mahieu P, Hollevoet N. Extensor tendon and fascia sectioning of extensors at the musculotendinous unit in lateral epicondylitis. Acta Orthop Belg. 2013;79:266-70.
Dunkow PD, Jatti M, Muddu BN. A comparison of open and percutaneous techniques in the surgical treatment of tennis elbow. JBJS(Br). 2004;86(5):701-4.
Maaty MT, Shennawy EMM, Naby AWL, Ahmad MS. Percutaneous combined common extensor origin release and drilling of lateral humeral epicondyle resistant tennis elbow. Benha Med J. 2015;32:137-40.
