Afsar Khan, Yaqoob-ur Rehman, Muhammad Zahid Shah, Abdus Samad Khan.
Percutaneous needle tenotomy in the treatment of resistant lteral epicondylitis.
Pak J Surg Jan ;35(2):151-5.

Objective: To assess the outcome of percutaneous needle tenotomy in the treatment of resistant lateral epicondylitis Study design: Descriptive study Place and duration of study: Outpatient Department (OPD) of Orthopedics and TraumaQazi Hussain Ahmad Medical Complex Nowshera and Private clinics in Kohat, KPK, Pakistan from January 2016 to December 2017. Materials and Methods: 20 patients with resistant lateral epicondylitis meeting the inclusion criteria were enrolled in the study. Each patient underwent percutaneous needle tenotomy of the common extensor tendon with 18G hypodermic needle under local anesthesia. Pre-procedure and post-procedure assessment at 12 weeks was doneusing VAS pain score and Nirschl stage. Results: Out of 20 patients, 16(80%) patients were females and 4(20%) were males. Average age of the patients was 40.75 years +- 8.03 SD. In 17(85%) patients, right elbow was involved while in 3(15%) patients, left elbow was involved. Most of the patients (15, 75%) were in the age range of 30-50 years. Mean duration of symptoms was 31.85weeks+-4.88SD. At 12 weeks, mean VAS pain score decreased from 8.05+-1.36SD to 1.35+-2.22SD while mean Nirschl stage decreased from 6.15+-0.85SD to 0.95+-1.63SD. Th ere was statistically signifi cant decrease in VAS pain score and Nirschl stage at 12 weeks (p-value <0.001). Treatment was successful in 70% (14) of patients (VAS pain score <= 2). Temporary pain at tenotomy site was reported by 2 (10%) patients. No case of hematoma formation or infection was reported. No patient was lost to follow up. Conclusion: Percutaneous needle tenotomy for resistant lateral epicondylitis is easy, safe, effective and minimally invasive procedure which can be done at outpatient department. We recommend long-term comparative study to confirm our results.

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