Journal Article Ppublish 7 citations
PubMed: 33358122 DOI: 10.1016/j.otsr.2020.03.016
Recalcitrant lateral epicondylitis: Early results with a new technique combining ultrasonographic percutaneous tenotomy with platelet-rich plasma injection.
Orthop Traumatol Surg Res 107(2):102604
Authors: Yacine Carlier, Françoise Bonichon, Alain Peuchant
Affiliations
- Department of orthopaedics, centre de l'arthrose de Mérignac (CAM), clinique du sport Bordeaux Mérignac, 2, rue Georges-Négrevergne, 33700 Mérignac, France.
- Department of statistics, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
- Department of biology, clinique du sport Bordeaux Mérignac, 2, rue Georges-Négrevergne, 33700 Mérignac, France.
Abstract
PURPOSE
Surgical treatment of recalcitrant lateral epicondylitis [LE] remains difficult, with suboptimal results. This prospective study aimed to determine whether percutaneous epicondylar tenotomy combined with PRP injection under ultrasonography control would optimize the surgery results, with an early gain on pain and strength and a rapid return to professional activities at 3 months. The secondary objective was to determine whether clinical or biological risk factors (e.g., composition of the PRP) affected the outcomes.
METHODS
A total number of 261 Patients with recalcitrant LE underwent percutaneous epicondylar tenotomy under ultrasonography control, coupled with PRP injection. All patients were clinically assessed using VAS pain scale, the functional scores: QuickDASH [Disabilities of the Arm, Shoulder and Hand], Patient-Rated Tennis Elbow Evaluation [PRTEE] and MEPS [Mayo Elbow Performance Score]; Elbow Self-Assessment Score [ESAS]; grip strength; and return to work.
RESULTS
At 3-month follow-up, the VAS score decreased by 3.4 points (SD 2.2; p<0.0001), the QuickDASH decreased by 32.9 points (SD 18.9, range 56.1-23.1; p<0.0001), the PRTEE decreased by 14.8 points (SD 19.1, 49.8-26.4; p=0.017), and the MEPS increased by 19.4 points (SD 13.1, 67.4-86.9; p<0.0001); grip strength increased to 8.3kg (SD 10.7; p<0.0001) and increased by 26% (SD 0.60, 0.7-0.96; p<0.0001) as compared with the opposite side. The ESAS showed 78.3% improvement.
CONCLUSION
Treatment of recalcitrant LE by percutaneous tenotomy combined with PRP injection under ultrasonography control provides rapid recovery in terms of pain and strength, with a high level of satisfaction and a high rate of early return to work.
STUDY DESIGN
Case series.
MeSH
Injections, General Surgery, Tennis Elbow, Pain, Ultrasonography, Blood Platelets, Platelet-Rich Plasma, Self-Assessment, Tenotomy, Recycling, Return To Work