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标准化肌腱开窗并注射自体血治疗肱骨外上髁炎

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis.

作者信息

Goorens Chul Ki, Wernaers Pascal, Dewaele Joost

机构信息

Department of Orthopaedics and Traumatology, Regionaal Ziekenhuis Tienen, Tienen, Belgium.

Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

出版信息

J Hand Microsurg. 2020 Sep 17;14(3):240-244. doi: 10.1055/s-0040-1716991. eCollection 2022 Jul.

Abstract

Lateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30-68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

摘要

肘部外侧上髁炎(LE)通常采用保守方法治疗。包括注射不同物质在内的多种技术被广泛应用。目前尚无标准化方案。这项前瞻性研究描述了56例平均年龄48岁(范围:30 - 68岁)患者使用即时网球肘治疗医疗器械进行短期随访的结果,该器械通过一个带有12根小针的固定器以标准化方式对受伤肌腱进行开窗。针的深度和位置预先通过超声检查确定。未处理的自体血通过固定器注入肌腱。6周后,静息时视觉模拟疼痛量表(VAS)显著下降61%,活动时下降47%。3个月后,静息时VAS显著下降79%,活动时下降66%。6个月后VAS无显著差异。6周时满意度为71%,6个月时为82%。这表明治疗效果持续存在,在某些情况下会随时间增强。患者相关网球肘评估评分在3个月后改善了71%。需要进行对比研究以证实与其他技术(如物理治疗、冲击波治疗以及注射其他物质)相比的效果。

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本文引用的文献

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Injection of tennis elbow: Hit and miss? A cadaveric study of injection accuracy.网球肘注射:盲目操作?一项关于注射准确性的尸体研究。
Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2289-2292. doi: 10.1007/s00167-016-4212-0. Epub 2016 Jul 2.

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