Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up

医学 上髁炎 耐火材料(行星科学) 动脉栓塞 外科 栓塞 网球肘 抢救疗法 保守治疗 放射科 肘部 天体生物学 物理
作者
Wataru Iwamoto,Yuji Okuno,Noboru Matsumura,Takao Kaneko,Hiroyasu Ikegami
出处
期刊:Journal of Shoulder and Elbow Surgery [Elsevier]
卷期号:26 (8): 1335-1341 被引量:44
标识
DOI:10.1016/j.jse.2017.03.026
摘要

Background

Abnormal vessels and accompanying nerves are possible sources of pain with lateral epicondylitis. The purpose of this study was to describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis resistant to conservative treatment.

Methods

This prospective study was conducted in 24 patients with lateral epicondylitis resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2014. Two patients were lost to follow-up, and the remaining 22 patients were followed up for 2 years after TAE.

Results

Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disabilities of the Arm, Shoulder and Hand scores at baseline significantly decreased at 1, 3, 6, and 24 months after treatment (50.8 vs 23.4, 8.3, 5.3, and 2.7, respectively; all P < .001). There was a statistically significant (P < .001) change from baseline to the last observed value in all of the clinical parameters, including visual analog scale pain score, Patient-Rated Tennis Elbow Evaluation score, and pain-free grip strength. Magnetic resonance images obtained 2 years after TAE showed an improvement in tendinosis and tear scores compared with baseline, and no patients showed bone marrow necrosis, obvious cartilage loss, or muscle atrophy.

Conclusion

TAE could be one possible treatment option for patients with lateral epicondylitis that fails to improve with conservative treatments.
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