Viswanathan Shashidharan, Shanker Harish Kashyap
Trauma and Orthopaedics, Royal Alexandra Hospital, Paisley, GBR.
Cureus. 2022 Oct 15;14(10):e30317. doi: 10.7759/cureus.30317. eCollection 2022 Oct.
Background Lateral epicondylitis or 'Tennis elbow' is a common cause of elbow pain in the middle-aged group caused by tendinosis of the common extensor origin of the forearm muscles. Though no obvious aetiology is identified in most cases, it could be attributed to repetitive overuse of wrist extensors or supinator muscles. This condition is generally self-limiting but may become persistent in a few cases. Radiofrequency microtenotomy (RFM) is a minimally invasive surgical procedure for recalcitrant lateral epicondylitis of the elbow. This involves targeted coblation of pathological tissue at significantly lower temperatures. Objectives The aim of this study was to evaluate the therapeutic efficacy and report long-term results and recurrences in patients treated with RFM. Methods We present long-term results with a mean eight-year follow-up in a case series of 19 patients. All patients had a minimum of six months (mean 23.25 months and range: 6-36 months) of conservative management which included steroid injections prior to being offered RFM. This was a retrospective case series of 20 elbows (in 19 patients) who underwent RFM. The majority of patients (65%) were females. The operation was carried out in the dominant arm in 55% of patients. Results Results were analysed by comparing pre-operative and post-operative QuickDASH scores (Disabilities of the Arm, Shoulder and Hand Score) obtained at one year and eight years post-operatively. We found an improvement in QuickDASH scores from a mean of 61.7 pre-operatively to 18.9 (p-value < 0.0001) and 8.5 (p-value < 0.0001) at one year and eight years, respectively. The mean pain component of the QuickDASH scores decreased from 4.8 to 2.0 and 1.5, respectively, at one year and eight years (p-value < 0.0001). More than 83% of the patients had excellent to good functional improvement. Conclusion RFM is a reliable modality for treating recalcitrant lateral epicondylitis of the elbow with excellent long-term results.
外侧上髁炎或“网球肘”是中年人群肘部疼痛的常见原因,由前臂肌肉的共同伸肌起点肌腱病引起。虽然大多数病例未发现明显病因,但可能归因于腕伸肌或旋后肌的反复过度使用。这种情况一般为自限性,但少数情况下可能会持续存在。射频微切开术(RFM)是一种用于治疗顽固性肘部外侧上髁炎的微创手术。这涉及在显著更低的温度下对病理组织进行靶向消融。
本研究的目的是评估RFM治疗的疗效,并报告长期结果和复发情况。
我们在一个19例患者的病例系列中呈现了平均八年随访的长期结果。所有患者在接受RFM之前至少有六个月(平均23.25个月,范围:6 - 36个月)的保守治疗,包括类固醇注射。这是一个对20个肘部(19例患者)进行RFM治疗的回顾性病例系列。大多数患者(65%)为女性。55%的患者在优势手臂进行手术。
通过比较术前和术后一年及八年获得的QuickDASH评分(手臂、肩部和手部功能障碍评分)来分析结果。我们发现QuickDASH评分从术前的平均61.7分别改善到术后一年的18.9(p值<0.0001)和术后八年的8.5(p值<0.0001)。QuickDASH评分的平均疼痛成分在术后一年和八年分别从4.8降至2.0和1.5(p值<0.0001)。超过83%的患者功能改善为优或良。
RFM是治疗顽固性肘部外侧上髁炎的可靠方法,长期效果良好。