Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Inter-university Laboratory of Human Movement Biology, "Physical Ability and Fatigue in health and disease" team (F-42023), Saint-Etienne "Jean Monnet" & Lyon 1 & "Savoie Mont-Blanc" universities, Saint- Etienne, France.
Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Inter-university Laboratory of Human Movement Biology, "Physical Ability and Fatigue in health and disease" team (F-42023), Saint-Etienne "Jean Monnet" & Lyon 1 & "Savoie Mont-Blanc" universities, Saint- Etienne, France.
Ann Phys Rehabil Med. 2024 Jun;67(5):101839. doi: 10.1016/j.rehab.2024.101839. Epub 2024 Jun 1.
Percutaneous needle tenotomies constitute a promising approach that enables direct access to tendons through minimally invasive interventions. They can be performed rapidly without need for large incisions or general anaesthesia. However, the reported procedures are heterogeneous and currently conducted without guidelines.
We aimed to determine the indications for percutaneous needle tenotomies described in the current literature. Our secondary aim was to identify the different procedures reported, as well as their efficacy and their safety.
A systematic review following PRISMA guidelines was conducted to identify original articles that mentioned percutaneous needle tenotomy in humans and reported its application, description, effectiveness or adverse events. Non-percutaneous tendinous surgical procedures and ineligible designs were excluded. The Downs and Black checklist was used to assess the risk of bias.
A total of 540 studies were identified from the MEDLINE, Embase, Cochrane Library, and PEDro databases. Fourteen clinical studies met the inclusion criteria and were found to have an acceptable quality (674 individuals, 1664 tenotomies). Our results indicated a wide variety of indications for percutaneous needle tenotomies in children and in adults. We highlighted 24 tendons as eligible targets in the upper and lower limbs. Tenotomies were performed with either 16- or 18-Ga needles, lasted from 1 to 30 min, and were performed using various procedures. Their efficacy was mainly assessed through clinical outcomes highlighting tendon discontinuity on palpation after the procedure. Passive range-of-motion gains after tenotomy were reported for both upper and lower limbs with an estimated 5 % complication rate.
This is the first review to systematically synthesize all the available evidence on the indications, procedures, efficacy and safety of percutaneous tenotomies exclusively performed with needles. Current evidence suggests that procedures are safe and effective for treating various deformities.
CRD42022350571.
经皮针刀切开术是一种很有前途的方法，它可以通过微创介入直接到达肌腱。这种方法可以快速进行，无需大切口或全身麻醉。然而，目前报道的手术方法具有异质性，且目前尚无指南。
我们旨在确定当前文献中描述的经皮针刀切开术的适应证。我们的次要目的是确定不同的报告程序，以及它们的疗效和安全性。
按照 PRISMA 指南进行系统评价，以确定提到人类经皮针刀切开术并报告其应用、描述、有效性或不良事件的原始文章。排除非经皮肌腱手术和不合格的设计。使用 Downs 和 Black 清单评估偏倚风险。
从 MEDLINE、Embase、Cochrane 图书馆和 PEDro 数据库中总共确定了 540 项研究。14 项临床研究符合纳入标准，被认为具有可接受的质量（674 人，1664 次切开术）。我们的结果表明，经皮针刀切开术在儿童和成人中有广泛的适应证。我们确定了上肢和下肢 24 根有适应证的肌腱。针刀切开术使用 16 或 18-Ga 针进行，持续 1 至 30 分钟，采用各种程序进行。其疗效主要通过术后触诊时肌腱连续性的临床结果来评估。上肢和下肢的被动活动范围在针刀切开术后均有增加，估计并发症发生率为 5%。
这是第一项系统综合所有关于经皮针刀切开术的适应证、程序、疗效和安全性的现有证据的综述，该手术仅使用针刀进行。目前的证据表明，这些手术对于治疗各种畸形是安全有效的。
PROSPERO 注册号：CRD42022350571。
