Rupe Marshall W, Fleury Ignacio Garcia, Glass Natalie, Kruse Ryan, Buckwalter V Joseph A
Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA.
J Hand Surg Glob Online. 2023 May 18;5(5):667-672. doi: 10.1016/j.jhsg.2023.04.004. eCollection 2023 Sep.
To determine the efficacy of treatment of lateral elbow tendinopathy (LET) with platelet-rich plasma (PRP) injection and ultrasonic tenotomy and debridement (USTD) as well as risk factors for treatment failure.
This was a retrospective study including patients treated for LET with PRP or USTD between January 2018 and December 2021. The efficacy of both procedures was assessed using pain-related patient-reported outcome measures at the 12-week follow-up. Baseline subject characteristics and diagnostic ultrasound findings were analyzed as risk factors for failure of treatment. Failure was classified as a surgical indication for LET within a year of the PRP or USTD.
Ultrasonic tenotomy and debridement and PRP both led to significant improvement in patient pain within the 12-week follow-up period. There was no significant difference in efficacy between the two procedures. Common extensor tendon tearing on ultrasound and Worker's Compensation cases were found to be risk factors for failure of USTD. Lateral collateral ligament complex involvement and injection were found to be risk factors for failure of PRP.
Platelet-rich plasma and USTD are both effective interventions for LET. They have separate risk factors for failure that should be taken in consideration while deciding the treatment approach. These procedures are minimally invasive alternatives to some of the more invasive surgical options to treat LET.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
确定富血小板血浆（PRP）注射联合超声肌腱切断术及清创术（USTD）治疗外侧肘肌腱病（LET）的疗效以及治疗失败的危险因素。
这是一项回顾性研究，纳入了2018年1月至2021年12月期间接受PRP或USTD治疗LET的患者。在12周随访时，使用与疼痛相关的患者报告结局指标评估两种治疗方法的疗效。分析基线受试者特征和诊断性超声检查结果作为治疗失败的危险因素。治疗失败被定义为在接受PRP或USTD治疗后一年内出现LET的手术指征。
在12周随访期内，超声肌腱切断术及清创术和PRP均使患者疼痛得到显著改善。两种治疗方法的疗效无显著差异。超声检查发现常见伸肌肌腱撕裂以及工伤赔偿案例是USTD治疗失败的危险因素。外侧副韧带复合体受累和注射是PRP治疗失败的危险因素。
富血小板血浆和USTD都是治疗LET的有效干预措施。它们有各自的治疗失败危险因素，在决定治疗方法时应予以考虑。这些治疗方法是治疗LET的一些侵入性更强的手术选择的微创替代方案。
研究类型/证据水平：治疗性III级。
