Facharzt für Orthopädie und Sportmedzin, Kümmellstr 1, 20249 Hamburg, Germany.
PM R. 2012 Mar;4(3):176-81. doi: 10.1016/j.pmrj.2011.11.003. Epub 2012 Feb 18.
To evaluate noninvasive monopolar capacitive-coupled radiofrequency (mcRF) for the treatment of pain associated with lateral elbow tendinopathies.
Prospective, single-center, single-arm, 1-year follow-up.
Private sports medicine practice.
Thirty-nine consecutive patients with diagnosis of lateral elbow tendinopathy (including 3 bilateral cases, for a total of 42 elbows) participated in the study. All patients had been unsuccessfully treated with a variety of nonoperative therapies (eg, nonsteroidal anti-inflammatory drugs, corticosteroid injections, and braces) for at least 3 months before they were enrolled in the study.
Patients were treated with mcRF technology in the office without local anesthetic or any particular preparation. Anatomic landmarks and careful determination of the most tender point defined the area treated; rapid and precise mcRF pulses were delivered covering the area in a staggered fashion; and 10 additional pulses were delivered directly to the point of maximum tenderness (total of 100 pulses). Patients returned to activities of daily living without restriction and were instructed to avoid nonsteroidal anti-inflammatory drugs and/or ice over the treated area. Physical therapy or other treatment modalities were disallowed.
The presence of pain before enrollment ranged from 15 weeks to 2 years (average, 32 weeks). Visual analog scores at rest, with regular activity, and with triggering events were gathered at 3, 6, and 12 months. The Nirschl Tennis Elbow Questionnaire and patient satisfaction also were used to evaluate study outcomes. Follow-up average was 423 days (range, 330-487 days). On the basis of the study's multifactorial success criteria, 81% of participants had successful outcomes. Furthermore, 89% of the patients who completed the study were completely or moderately satisfied with the outcome.
Outcomes of this study suggest that noninvasive mcRF may have a role in the treatment of pain associated with lateral elbow tendinopathies. The noninvasive nature of the procedure and the safety and efficacy suggested by this study may offer significant advantages over current treatment alternatives. Further research in the form of a randomized clinical trial is recommended.
评估非侵入性单极电容耦合射频(mcRF)治疗外侧肘肌腱病相关疼痛。
前瞻性、单中心、单臂、1 年随访。
私人运动医学诊所。
39 例连续诊断为外侧肘肌腱病的患者(包括 3 例双侧病例,共 42 肘)参加了这项研究。所有患者在接受研究之前,已接受各种非手术治疗(如非甾体抗炎药、皮质类固醇注射和支具)至少 3 个月,但均未成功。
患者在办公室接受 mcRF 技术治疗,无需局部麻醉或任何特殊准备。解剖标志和仔细确定最痛点定义了治疗区域;快速准确地递送电刺激脉冲,交错覆盖该区域;并在最痛点直接给予 10 个额外的电刺激脉冲(共 100 个脉冲)。患者返回日常生活,不受限制,并被指示避免在治疗区域使用非甾体抗炎药和/或冰敷。不允许使用物理疗法或其他治疗方式。
入组前疼痛持续时间从 15 周至 2 年不等(平均 32 周)。在 3、6 和 12 个月时,收集静息时、日常活动时和触发事件时的视觉模拟评分。Nirschl 网球肘问卷和患者满意度也用于评估研究结果。平均随访时间为 423 天(范围 330-487 天)。根据研究的多因素成功标准,81%的参与者获得了成功的结果。此外,完成研究的患者中有 89%对结果完全或中度满意。
本研究结果表明,非侵入性 mcRF 可能在治疗外侧肘肌腱病相关疼痛方面发挥作用。该治疗方法的非侵入性性质,以及本研究显示的安全性和有效性,可能比目前的治疗选择具有显著优势。建议进一步开展随机临床试验。