Evaluation of the efficiency of an ultrasound-supported infiltration technique in patients with tennis elbow applying the ITEC medical device: a multicenter study

Abstract

BackgroundThe treatment of lateral epicondylitis (LE) remains unsatisfactory in certain cases. The aim of this study is to investigate the efficiency of an ultrasound-guided infiltration combined with fenestration of the extensor tendon postulating a 50% reduction in pain on exertion within 6 months. MethodsIn a prospective, non-randomized, multi - center study design, 68 patients with chronic LE and symptoms lasted of at least 6 weeks were included. Each hospital has been assigned either for Traumeel (A), autologous whole blood (B) or dextrose (C) in advance. Preinterventional, 6 weeks, 12 weeks, 6 and 12 months after infiltration, patient related outcome parameter and dorsal wrist extension strength were documented. Pre - interventional (obligate) and after 6 months (optional) radiological evaluation (MRI) was performed. ResultsThe Visual Analog Scale (VAS) showed a significant reduction after 6 months in all groups (A. from 4.8 to 2.5, B. 6.2 to 2.3, C. 5.8 to 2.4). Similar results could be observed with SEV, DASH, MEPS and PRTEE. The loss of strength could be completely compensated after about 6 months. MRI did not fully reflect clinical convalescence. Re-infiltrations were sometimes necessary for final reduction of symptoms (A=11, B=8, C=4). Switching to surgical intervention was most frequent observed in group C (A=2, B=1, C=5). In 14.5% of the cases, no improvement of the symptoms could be achieved with this method. ConclusionThe primary hypothesis of a significant long-term pain reduction of at least 50% could be achieved regardless of the medication chosen.