Ultrasound-guided tenotomy improves physical function and decreases pain for tendinopathies of the elbow: a retrospective review

BACKGROUND: Tendinopathy is a common cause of elbow pain in the active population. Ultrasound Guided Tenotomy (USGT) is a minimally invasive treatment option for cases recalcitrant to conservative management. Several case studies have shown promising preliminary results of USGT for common extensor tendinopathy and common flexor tendinopathy, but none have included USGT for triceps tendinopathy. This larger retrospective study evaluates the effectiveness and safety of USGT for all elbow tendinopathy sites at short and long-term follow-up. METHODS: Retrospective chart review identified 131 patients [144 procedures] (mean age ± SD, 48.1 ± 9.8 years; mean body mass index ± SD, 32.2 ± 7.7 kg/m(2); 59% male) with elbow tendinopathy (104 common extensor tendinopathy; 19 common flexor tendinopathy; 8 triceps tendinopathy) treated with USGT over a 6-year period by a single physician. Pain and quality of life measures were collected at baseline. Pain, quality of life, satisfaction with outcome, and complications were collected at short-term (2, 6, 12 week) and long-term (median 2.7 years IQR= 2.0 to 4.0 years) follow-up. RESULTS: Overall, USGT for elbow tendinopathy decreased pain from moderate/severe at baseline to mild/occasional at short-term and long-term follow-up (p< 0.01). Quality of life assessments showed significant improvement in physical function at short and long-term follow-up (p< 0.01). The majority (70%) of patients were satisfied with the procedure. There was a 0% complication rate. CONCLUSION: Benefits of USGT include pain relief, improved physical function, and high patient satisfaction. USGT is a safe minimally invasive treatment for refractory elbow tendinopathy.