ABSTRACT
Background: Tennis elbow (lateral epicondylitis elbow) is a self-limiting disease of indeterminate pathogenesis. Conservative therapy is the treatment of choice. In chronic tennis elbow with failure of conservative therapy; surgical treatment is a method of choice. Percutaneous tenotomy of extensor origin for patients with chronic tennis elbow is a minimally invasive technique with better long-term outcomes. Case Report: Ten patients (six males, four females) presented with chronic tennis elbow, who did not respond to conservative treatment/non-surgical intervention for more than 6 months underwent percutaneous tenotomy in an outpatient setting. Two patients were lost to follow-up at 2 months' post-operative. The remaining eight patients were evaluated at a mean follow-up of 3 years and assessed using the numerical rating scale, disabilities of the arm, shoulder and hand questionnaire ,and Oxford elbow score. These scores had a statistically significant difference in baseline to 3-year follow-up values (P < 0.05). No adverse outcomes, recurrence of symptoms, and signs of lateral epicondylitis elbow were noted and none required open surgical release. Conclusion: Percutaneous tenotomy, a minimally invasive technique is an effective and well-tolerated treatment for chronic tennis elbow and gives good pain relief and functional recovery.
ABSTRACT
PURPOSE: To compare the effects of three modalities of pain management i.e. SSNB (suprascapular nerve block) with NIR (non invasive rehabilitation), IAI (intra articular injection) with NIR and, NIR alone in idiopathic frozen shoulder patients. METHODS: A double blinded randomized clinical trial was conducted. 60 cases of idiopathic frozen shoulder were selected and randomly divided into three treatment groups; group 1: NIR, group 2: NIR + SSNB, group 3: NIR +IAI. Range of motion, pain score and disability (SPADI: shoulder pain and disability index) score were evaluated pre-treatment and at 12 weeks follow up. RESULTS: All three groups were homogenous and comparable regarding their age, sex ratio, pretreatment pain score, disability score and range of motion. There was significant improvement (p < 0.05) post treatment in all three groups with respect to pain score, disability score and range of motion. SSNB with NIR group patients demonstrated better improvement in all parameters examined, which was statistically significant in pain score, disability score and internal rotation but was statistically equivalent for total range of motion and external rotation as compared to shoulder injection group. CONCLUSION: SSNB in combination with non invasive rehabilitation is an effective and safe mode of treatment for idiopathic frozen shoulder. Present study also proves that SSNB with NIR is a more effective mode of treatment for idiopathic frozen shoulder as compared to NIR alone or in combination with IAI.Level of evidence: Level 1.
