Extracorporeal shock-wave therapy for chronic lateral tennis elbow - prediction of outcome by imaging

Citation
M. Maier et al., Extracorporeal shock-wave therapy for chronic lateral tennis elbow - prediction of outcome by imaging, ARCH ORTHOP, 121(7), 2001, pp. 379-384
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
ISSN journal
0936-8051 → ACNP
Volume
121
Issue
7
Year of publication
2001
Pages
379 - 384
Database
ISI
SICI code
0936-8051(200107)121:7<379:ESTFCL>2.0.ZU;2-E
Abstract
Today the clinical use of extracorporeal shockwave application (ESWA) for t he treatment of lateral tennis elbow is hampered by the lack of results fro m randomized controlled trials and of predictive parameters of clinical out come. The present prospective study aimed to provide the latter by means of magnetic resonance imaging (MRI). Twenty-three female and 19 male patients with unilateral chronic tennis elbow of the dominant site were clinically examined before and after repetitive low-energy ESWA. MRI was performed bef ore ESWA to evaluate signal intensity changes or contrast enhancement of th e common extensor tendon and the lateral epicondyle. After ESWA (mean follo w-up period 18.6 months for all patients), clinical evaluation showed a sig nificantly better mean clinical performance after ESWA than before treatmen t. Interestingly, male patients showed a significantly better mean clinical performance after ESWA than female patients, and male and female patients differed significantly in the signal intensity of the common extension tend on cross-section and tendon thickening on MRI. For female patients, MRI sca ns could be applied for predicting a positive clinical outcome of ESWA. Thi s study reports the first indication of predictability of positive clinical outcome of the treatment of chronic lateral tennis elbow by ESWA using ima ging prior to treatment. This may serve as an important step towards overco ming the therapeutic nihilism with respect to the non-operative management of this condition recently in the literature.