title: Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow: is a corticosteroid necessary?
abstract: OBJECTIVE
  Chronic refractory common extensor tendinosis of the lateral elbow has been shown to respond to sonographically guided percutaneous needle tenotomy (PNT) followed by corticosteroid injection. In this analysis, we attempted to determine whether the corticosteroid is a necessary component of the procedure.
  
  
  METHODS
  We performed PNT on 57 consecutive patients (age range, 34-61 years) with persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the tendon, and the tip of the needle was used to fenestrate the tendinotic tissue, break up any calcifications, and abrade the adjacent bone. After the procedure, patients underwent a specified physical therapy protocol. During a subsequent telephone interview, patients answered questions about their symptoms, the level of functioning, and perceptions of the procedure outcome.
  
  
  RESULTS
  Of the 52 patients who agreed to participate in the study, 30 (57.7%) reported excellent outcomes, 18 (34.6%) good, 1 (1.9%) fair, and 3 (5.8%) poor. The average follow-up time from the date of the procedure to the telephone interview was 22 months (range, 7-38 months). No adverse events were reported, and 90% stated that they would refer a friend or close relative for the procedure.
  
  
  CONCLUSIONS
  Sonographically guided PNT for refractory lateral elbow tendinosis is an effective procedure, and subsequent corticosteroid injection is not necessary.
authors.affiliation: McShane Sports Medicine, 734 E Lancaster Ave, Villanova, PA 19085, USA. bjmcshane@pol.net
authors.forename: John M
authors.initials: JM
authors.lastname: McShane
authors.forename: Vinil N
authors.initials: VN
authors.lastname: Shah
authors.forename: Levon N
authors.initials: LN
authors.lastname: Nazarian
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D004550:Elbow / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D025321:Surgery, Computer-Assisted / Q000379:methods*; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones