Andrew's Sports Medicine and Orthopedic Center, Pelham, AL.
American Sports Medicine Institute, Birmingham, AL.
Medicine (Baltimore). 2022 Aug 5;101(31):e29957. doi: 10.1097/MD.0000000000029957.
Lateral epicondylitis is one of the most common causes of elbow pain. Most patients recover with conservative treatments; however, some patients require surgical intervention. There are 3 common procedures offered: open tenotomy, arthroscopic tenotomy, and percutaneous microtenotomy. In comparison, percutaneous microtenotomy has been proven as a less invasive procedure to treat lateral epicondylitis. We reviewed the literature on the safety and efficacy of using a microdebrider coblation wand to treat lateral epicondylitis, and we compared its outcomes to open and arthroscopic tenotomy.
A search was completed through PubMed Central, Google Scholar, EBSCO host, and Embase for studies that performed percutaneous microtenotomy with a microdebrider coblation wand to treat lateral epicondylitis. Studies were then screened to determine if they met inclusion and exclusion criteria and were reviewed for data analysis and potential risks of bias.
A total of 27 articles were identified and 9 articles (eight studies) met the inclusion criteria. Small sample sizes in the studies and heterogeneity of the methodology limited the capacity to carry out a meta-analysis. Percutaneous microtenotomy outcomes seem to be favorable for reduced pain, increased grip strength, and improved functional outcomes, which were similar to outcomes reported with the other surgical techniques. There were no major adverse events reported in the studies secondary to the use of the microdebrider coblation wand. Procedure time and return to daily activities were shorter for the microtenotomy group.
Percutaneous microtenotomy performed with a microdebrider coblation seems to be an effective treatment for lateral epicondylitis that provides similar outcomes to the surgical techniques with a lower rate of complications.
外侧肱骨上髁炎是肘部疼痛最常见的原因之一。大多数患者通过保守治疗即可康复;然而,有些患者需要手术干预。目前有 3 种常见的手术方法:开放性肌腱切开术、关节镜下肌腱切开术和经皮微切开术。相比之下,经皮微切开术已被证明是一种治疗外侧肱骨上髁炎的微创方法。我们回顾了使用微刨削器旋切刀治疗外侧肱骨上髁炎的安全性和有效性的文献,并将其结果与开放性和关节镜下肌腱切开术进行了比较。
通过 PubMed Central、Google Scholar、EBSCO 主机和 Embase 搜索了使用微刨削器旋切刀治疗外侧肱骨上髁炎的经皮微切开术研究。然后筛选这些研究以确定它们是否符合纳入和排除标准,并对其进行数据分析和潜在偏倚风险的审查。
共确定了 27 篇文章,其中 9 篇(8 项研究)符合纳入标准。研究中的样本量小且方法学的异质性限制了进行荟萃分析的能力。经皮微切开术的结果似乎有利于减轻疼痛、增加握力和改善功能结局,这与其他手术技术报告的结果相似。由于使用微刨削器旋切刀,研究中没有报告重大不良事件。微切开组的手术时间和恢复日常活动的时间更短。
使用微刨削器旋切的经皮微切开术似乎是治疗外侧肱骨上髁炎的有效方法,其提供的结果与手术技术相似,但并发症发生率较低。