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Erschienen in:

04.06.2021 | Clinical Investigation

Short-term Results of Transcatheter Arterial Embolization for Chronic Medial Epicondylitis Refractory to Conservative Treatment: A Single-Center Retrospective Cohort Study

verfasst von: Jae Hwan Lee, Dong Hyun Kim, Sang Hwan Lee, Jin Ho Hwang, Soo Buem Cho, Minuk Kim, Young Ho So, Young Jae Kim, Won Seok Choi, Chang Jin Yoon

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2022

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Abstract

Purpose

To evaluate the effectiveness and safety of transcatheter arterial embolization (TAE) for chronic medial epicondylitis (ME) refractory to conservative treatments.

Materials and Methods

This retrospective study included ten patients (14 procedures) who underwent TAE between May of 2018 and April of 2020 to treat chronic ME refractory to conservative treatments for at least 3 months. Imipenem/cilastatin sodium was used in 12 procedures, and quick-soluble gelatin sponge particles were used in the ensuing two procedures as an embolic agent. The visual analogue scale (VAS, 0–10) score and Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scores were assessed at baseline and at different post-treatment times (1 day; 1 week; 1, 3, and 6 months; and an open period). The clinical success of the procedure was defined as a decrease of more than 70% in the Quick-DASH scores at 6 months compared to the baseline.

Results

Clinical success was achieved in 12 of 14 procedures (85.7%). No major complications were observed during the follow-up periods. The mean VAS scores were significantly decreased at 1 day, 1 week, 1 month, 3 months and 6 months (7.6 at baseline vs. 3.6, 3.6, 3.6, 3, and 0.9 after treatment; all P < .01). The mean Quick-DASH scores at baseline decreased significantly at 1 day, 1 week, and at 1, 3, and 6 months after treatment (71.9 vs. 48.5, 44, 37.7, 30.2, and 8.4; all P < .01). These improvements endured in nine patients for up to 12 months after treatment.

Conclusion

TAE effectively and safely relieved pain and promoted functional recovery in chronic ME patients refractory to conservative treatments. TAE may be a feasible treatment option for patients with ME intractable to conservative treatments.
Literatur
1.
Zurück zum Zitat Harrington JM, Carter JT, Birrell L, Gompertz D. Surveillance case definitions for work related upper limb pain syndromes. Occup Environ Med. 1998;55:264–71.CrossRef Harrington JM, Carter JT, Birrell L, Gompertz D. Surveillance case definitions for work related upper limb pain syndromes. Occup Environ Med. 1998;55:264–71.CrossRef
2.
Zurück zum Zitat Tarpada SP, Morris MT, Lian J, Rashidi S. Current advances in the treatment of medial and lateral epicondylitis. J Orthop. 2018;15:107–10.CrossRef Tarpada SP, Morris MT, Lian J, Rashidi S. Current advances in the treatment of medial and lateral epicondylitis. J Orthop. 2018;15:107–10.CrossRef
3.
Zurück zum Zitat Descatha A, Leclerc A, Chastang J-F, Roquelaure Y. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med. 2003;45:993.CrossRef Descatha A, Leclerc A, Chastang J-F, Roquelaure Y. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med. 2003;45:993.CrossRef
4.
Zurück zum Zitat Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164:1065–74.CrossRef Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164:1065–74.CrossRef
5.
Zurück zum Zitat Ikpe S, Lesniak B. Biologics and cell-based treatments for upper extremity injuries. Oper Tech Orthop. 2016;26:177–81.CrossRef Ikpe S, Lesniak B. Biologics and cell-based treatments for upper extremity injuries. Oper Tech Orthop. 2016;26:177–81.CrossRef
6.
Zurück zum Zitat Lee SS, Kang S, Park NK, et al. Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Ann Rehabil Med. 2012;36:681.CrossRef Lee SS, Kang S, Park NK, et al. Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Ann Rehabil Med. 2012;36:681.CrossRef
7.
Zurück zum Zitat Binder A, Hazleman B. Lateral humeral epicondylitis—a study of natural history and the effect of conservative therapy. Rheumatology. 1983;22:73–6.CrossRef Binder A, Hazleman B. Lateral humeral epicondylitis—a study of natural history and the effect of conservative therapy. Rheumatology. 1983;22:73–6.CrossRef
8.
Zurück zum Zitat Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008;466:1539–54.CrossRef Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008;466:1539–54.CrossRef
9.
Zurück zum Zitat Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence? Clin Sports Med. 2012;31:329–50.CrossRef Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence? Clin Sports Med. 2012;31:329–50.CrossRef
10.
Zurück zum Zitat Baumgard SH, Schwartz DR. Percutaneous release of the epicondylar muscles for humeral epicondylitis. Am J Sports Med. 1982;10:233–6.CrossRef Baumgard SH, Schwartz DR. Percutaneous release of the epicondylar muscles for humeral epicondylitis. Am J Sports Med. 1982;10:233–6.CrossRef
11.
Zurück zum Zitat Gabel GT, Morrey B. Operative treatment of medial epicondylitis. J Bone Joint Surg. 1995;77:1065–9.CrossRef Gabel GT, Morrey B. Operative treatment of medial epicondylitis. J Bone Joint Surg. 1995;77:1065–9.CrossRef
12.
Zurück zum Zitat Iwamoto W, Okuno Y, Matsumura N, et al. 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. J Shoulder Elbow Surg. 2017;26:1335–41.CrossRef Iwamoto W, Okuno Y, Matsumura N, et al. 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. J Shoulder Elbow Surg. 2017;26:1335–41.CrossRef
13.
Zurück zum Zitat Okuno Y, Matsumura N, Oguro S. Transcatheter arterial embolization using imipenem/cilastatin sodium for tendinopathy and enthesopathy refractory to nonsurgical management. J Vasc Interv Radiol. 2013;24:787–92.CrossRef Okuno Y, Matsumura N, Oguro S. Transcatheter arterial embolization using imipenem/cilastatin sodium for tendinopathy and enthesopathy refractory to nonsurgical management. J Vasc Interv Radiol. 2013;24:787–92.CrossRef
14.
Zurück zum Zitat Hwang JH, Park SW, Kim KH, et al. Early results of transcatheter arterial embolization for relief of chronic shoulder or elbow pain associated with tendinopathy refractory to conservative treatment. J Vasc Interv Radiol. 2018;29:510–7.CrossRef Hwang JH, Park SW, Kim KH, et al. Early results of transcatheter arterial embolization for relief of chronic shoulder or elbow pain associated with tendinopathy refractory to conservative treatment. J Vasc Interv Radiol. 2018;29:510–7.CrossRef
15.
Zurück zum Zitat Okuno Y, Iwamoto W, Matsumura N, et al. Clinical outcomes of transcatheter arterial embolization for adhesive capsulitis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(161–167):e161.CrossRef Okuno Y, Iwamoto W, Matsumura N, et al. Clinical outcomes of transcatheter arterial embolization for adhesive capsulitis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(161–167):e161.CrossRef
16.
Zurück zum Zitat Okuno Y, Oguro S, Iwamoto W, et al. Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot study. J Shoulder Elbow Surg. 2014;23:e199–206.CrossRef Okuno Y, Oguro S, Iwamoto W, et al. Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot study. J Shoulder Elbow Surg. 2014;23:e199–206.CrossRef
17.
Zurück zum Zitat Filippiadis D, Binkert C, Pellerin O, et al. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40:1141–6.CrossRef Filippiadis D, Binkert C, Pellerin O, et al. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40:1141–6.CrossRef
18.
Zurück zum Zitat Alfredson H, Öhberg L, Forsgren S. Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? Knee Surg Sports Traumatol Arthrosc. 2003;11:334–8.CrossRef Alfredson H, Öhberg L, Forsgren S. Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? Knee Surg Sports Traumatol Arthrosc. 2003;11:334–8.CrossRef
19.
Zurück zum Zitat Jackson JR, Seed MP, Kircher CH, et al. The codependence of angiogenesis and chronic inflammation. FASEB J. 1997;11:457–65.CrossRef Jackson JR, Seed MP, Kircher CH, et al. The codependence of angiogenesis and chronic inflammation. FASEB J. 1997;11:457–65.CrossRef
20.
Zurück zum Zitat Bonnet C, Walsh D. Osteoarthritis, angiogenesis and inflammation. Rheumatology. 2005;44:7–16.CrossRef Bonnet C, Walsh D. Osteoarthritis, angiogenesis and inflammation. Rheumatology. 2005;44:7–16.CrossRef
21.
Zurück zum Zitat Perrot S, Guilbaud G. Pathophysiology of joint pain. Rev Rhum Engl Ed. 1996;63:485–92.PubMed Perrot S, Guilbaud G. Pathophysiology of joint pain. Rev Rhum Engl Ed. 1996;63:485–92.PubMed
22.
Zurück zum Zitat Lee SH, Hwang JH, Kim DH, et al. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol. 2019;42:1530–6.CrossRef Lee SH, Hwang JH, Kim DH, et al. Clinical outcomes of transcatheter arterial embolisation for chronic knee pain: mild-to-moderate versus severe knee osteoarthritis. Cardiovasc Intervent Radiol. 2019;42:1530–6.CrossRef
23.
Zurück zum Zitat Okuno Y, Korchi AM, Shinjo T, Kato S. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol. 2015;38:336–43.CrossRef Okuno Y, Korchi AM, Shinjo T, Kato S. Transcatheter arterial embolization as a treatment for medial knee pain in patients with mild to moderate osteoarthritis. Cardiovasc Intervent Radiol. 2015;38:336–43.CrossRef
24.
Zurück zum Zitat Bagla S, Piechowiak R, Hartman T, et al. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2020;31:1096–102.CrossRef Bagla S, Piechowiak R, Hartman T, et al. Genicular artery embolization for the treatment of knee pain secondary to osteoarthritis. J Vasc Interv Radiol. 2020;31:1096–102.CrossRef
25.
Zurück zum Zitat Okuno Y, Korchi AM, Shinjo T, et al. Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28:995–1002.CrossRef Okuno Y, Korchi AM, Shinjo T, et al. Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28:995–1002.CrossRef
Metadaten
Titel
Short-term Results of Transcatheter Arterial Embolization for Chronic Medial Epicondylitis Refractory to Conservative Treatment: A Single-Center Retrospective Cohort Study
verfasst von
Jae Hwan Lee
Dong Hyun Kim
Sang Hwan Lee
Jin Ho Hwang
Soo Buem Cho
Minuk Kim
Young Ho So
Young Jae Kim
Won Seok Choi
Chang Jin Yoon
Publikationsdatum
04.06.2021
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 2/2022
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-021-02878-2

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