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by the American Institute of Ultrasound in Medicine J Ultrasound Med 25:1281-1289 • 0278-4297 Sonographically Guided Percutaneous Needle Tenotomy for Treatment of Common Extensor Tendinosis in the ElbowMcShane Sports Medicine, Villanova, Pennsylvania USA (J.M.M.); and Department of Radiology (L.N.N.) and Department of Family and Community Medicine, Division of Sports Medicine (M.I.H.), Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania USA. Address correspondence to John M. McShane, MD, McShane Sports Medicine, 734 E Lancaster Ave, Villanova, PA 19085 USA. E-mail: bjmcshane{at}pol.net
Objective. Chronic tendinosis of the common extensor tendon of the lateral elbow can be a difficult problem to treat. We report our experience with sonographically guided percutaneous needle tenotomy to relieve pain and improve function in patients with this condition. Methods. We performed sonographically guided percutaneous needle tenotomy on 58 consecutive patients who had persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the common extensor tendon, and the tip of the needle was used to repeatedly fenestrate the tendinotic tissue. Calcifications, if present, were mechanically fragmented, and the adjacent bony surface of the apex and face of the epicondyle were abraded. Finally, the fenestrated tendon was infiltrated with a solution containing corticosteroid mixed with bupivacaine. After the procedure, patients were instructed to perform passive stretches and to undergo physical therapy. During a subsequent telephone interview, patients answered questions about their experience, their functioning level, and their perceptions of procedure outcome. Results. Fifty-five (95%) of 58 patients were contacted by telephone and agreed to participate in the study. Thirty-five (63.6%) of 55 respondents reported excellent outcomes, 16.4% good, 7.3% fair, and 12.7% poor. The average follow-up time from the date of the procedure to the date of the interview was 28 months (range, 17–44 months). No adverse events were reported; 85.5% stated that they would refer a friend or close relative for the procedure. Conclusions. Sonographically guided percutaneous needle tenotomy for lateral elbow tendinosis is a safe, effective, and viable alternative for patients in whom all other nonsurgical treatments failed.
Key Words: common extensor tendon • elbow • needle • sonography • tennis elbow • tendinosis Abbreviations: CET, common extensor tendon This article has been cited by other articles:
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