Ultrasound-guided percutaneous bone drilling for the treatment of lateral epicondylitis

Eur Radiol. 2018 Jan;28(1):390-397. doi: 10.1007/s00330-017-4932-7. Epub 2017 Jul 4.

Abstract

Objective: To determine the clinical efficacy of sonographically-guided percutaneous bone drilling of the lateral epicondyle (LE) for the treatment of patients with LE.

Methods: We included 24 patients with LE who reported pain in this study. All patients underwent sonographically-guided percutaneous bone drilling of the lateral epicondyle. Follow-up sonography and physical examinations were performed 1, 3 and 6 months after the procedure. The outcome measures included sonographic findings, visual analogue scale (VAS) score, maximum voluntary grip strength (MVGS) and patient-related tennis elbow evaluation (PRTEE) score.

Results: None of the patients had immediate complications during the procedure. The area of the extensor carpi radialis brevis (ECRB) tears decreased significantly at 1 month and declined gradually over the remaining 5 months of the study (p < 0.001). The mean pain VAS score was significantly lower at 6 months than preoperatively (respectively; p < 0.001). The mean MVGS increased significantly between pretreatment and 6 months post-treatment (p < 0.001), whereas the PRTEE score decreased significantly during the same period (p < 0.001).

Conclusion: Sonographically-guided percutaneous drilling is a quick and safe treatment option for LE that can be performed in an outpatient setting.

Key points: • Percutaneous drilling of the lateral condyle is effective for the treatment of LE. • The area of ECRB tears can be measured by US-guided saline injection. • US-guided percutaneous drilling is a quick and safe treatment option for LE.

Keywords: Elbow joint; Sports medicine; Tennis elbow; Treatment outcome; Ultrasonography.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Surgery, Computer-Assisted / methods*
  • Tennis Elbow / diagnostic imaging
  • Tennis Elbow / surgery*
  • Treatment Outcome
  • Ultrasonography / methods*