Tasto James P, Cummings Jeffrey, Medlock Virgil, Hardesty Renee, Amiel David
San Diego Sports Medicine and Orthopedic Center, University of California, San Diego, La Jolla, California, USA.
Arthroscopy. 2005 Jul;21(7):851-60. doi: 10.1016/j.arthro.2005.03.019.
To evaluate the safety and effectiveness of microtenotomy using a radiofrequency (RF) probe to treat chronic tendinosis of the common extensor tendon origins of the elbow (lateral epicondyle).
Prospective, nonrandomized consecutive case series.
The average age of the 13 patients was 48.3 +/- 5.5 years. Before receiving the microtenotomy, all patients had tendinosis symptoms for 6 months or longer and had failed conservative treatment. The RF-based microdebridement was performed on the symptomatic tendon using the TOPAZ Microdebrider device (ArthroCare, Sunnyvale, CA). Patients were followed-up at regular postoperative intervals for 24 months. Pain status was documented using a visual analog scale self-reported measure. Functional outcome was assessed using the upper limb DASH evaluation and grip-strength measures. Quality of life assessment was evaluated using the SF-36 questionnaire. Magnetic resonance imaging was performed at regular intervals over the follow-up period.
Patients reported significantly reduced pain from baseline at the 7- to 10-day postoperative examination (P < or = .01). Pain reduction was statistically stable from 7 to 10 days through the 24-month postoperative period (P < or = .01). Limb-specific functional outcomes and quality of life scores were improved over baseline values. There were no perioperative or postoperative complications related to the procedure.
The RF-based microtenotomy procedure was safe and effective through at least 2 years. This procedure provides a valuable addition for treating patients with lateral epicondylitis associated with tendinosis who have failed conservative therapy.
Level IV.
评估使用射频（RF）探头进行微切开术治疗肘部（外侧上髁）常见伸肌腱起点慢性肌腱病的安全性和有效性。
前瞻性、非随机连续病例系列。
13例患者的平均年龄为48.3±5.5岁。在接受微切开术之前，所有患者均有6个月或更长时间的肌腱病症状，且保守治疗无效。使用TOPAZ微型清创器设备（ArthroCare，加利福尼亚州桑尼维尔）对有症状的肌腱进行基于射频的微创清创术。术后定期对患者进行24个月的随访。使用视觉模拟量表自我报告测量记录疼痛状态。使用上肢DASH评估和握力测量评估功能结果。使用SF-36问卷评估生活质量。在随访期间定期进行磁共振成像检查。
患者报告在术后7至10天的检查中疼痛较基线显著减轻（P≤0.01）。从术后7至10天到术后24个月，疼痛减轻在统计学上保持稳定（P≤0.01）。肢体特定功能结果和生活质量评分均高于基线值。没有与该手术相关的围手术期或术后并发症。
基于射频的微切开术至少在2年内是安全有效的。该手术为治疗保守治疗失败的伴有肌腱病的外侧上髁炎患者提供了一种有价值的补充治疗方法。
四级。
