Abstract
Introduction
This report evaluates the efficacy of percutaneous needle puncture under sonographic guidance in treating lateral epicondylitis (tennis-elbow).
Methods
Ultrasound-guided percutaneous needle puncture was performed on 76 patients who presented with persistent elbow pain. Under a local anesthetic and sonographic guidance, a needle was advanced into the calcification foci and the calcifications were mechanically fragmented. This was followed by a local injection of 25 mg prednisone acetate and 1% lidocaine. If no calcification was found then multiple punctures were performed followed by local injection of 25 mg prednisone acetate and 1% lidocaine. A visual analog scale (VAS) was used to evaluate the degree of pain pre-and posttreatment at 1 week to 24 weeks. Elbow function improvement and degree of self-satisfaction were also evaluated.
Results
Of the 76 patients, 55% were rated with excellent treatment outcome, 32% good, 11% average, and 3% poor. From 3 weeks posttreatment, VAS scores were significantly reduced compared with the pretreatment score (P<0.05) and continued to gradually decline up to 24 weeks posttreatment. Sonography demonstrated that the calcified lesions disappeared completely in 13% of the patients, were reduced in 61% of the patients, and did not change in 26% of the patients. Color Doppler flow signal used to assess hemodynamic changes showed a significant improvement after treatment in most patients.
Conclusion
Ultrasound-guided percutaneous needle puncture is an effective and minimally invasive treatment for tennis elbow. Sonography can be used to accurately identify the puncture location and monitor changes.
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Zhu, J., Hu, B., Xing, C. et al. Ultrasound-guided, minimally invasive, percutaneous needle puncture treatment for tennis elbow. Adv Therapy 25, 1031–1036 (2008). https://doi.org/10.1007/s12325-008-0099-6
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DOI: https://doi.org/10.1007/s12325-008-0099-6