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Short- to mid-term follow-up effectiveness of US-guided focal extracorporeal shock wave therapy in the treatment of elbow lateral epicondylitis

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Abstract

Background

Lateral epicondylitis of the elbow is a common and disabling overuse syndrome. Several treatment modalities are currently available for this condition, but the optimal treatment method remains undefined. Extracorporeal shock wave therapy (ESWT) has been widely used in the last 10 years, although conflicting results are present in the literature.

Materials and methods

In this study, we evaluated 36 patients (37 elbows), with a mean follow-up time of 24.8 months. Focal ESWT was administered by means of an electromagnetic generator equipped with in-line ultrasound guidance, during one or more cycles of 3–4 weekly sessions. In the setting of the study, patients were clinically evaluated and subjective satisfaction and rate of relapse were investigated.

Results

A positive response was described in 75.7 % of the patients after treatment. Mean quickDASH score and VAS attested at 5.5 and 1.1, respectively. Roles and Maudsley score was rated as I or II in 33 cases. Four patients resulted not responders to the therapy, while 5 patients complained one or more episodes of symptoms relapse. No influence on the final outcome was evident with respect to demographic features and previous therapies as well. Response rate to further ESWT cycles in patients refractory to the first cycle of ESWT was 33.3 %.

Conclusions

Focal ESWT represents a valuable and safe solution in case of elbow lateral epicondylitis, both in newly diagnosed and previously treated cases, representing a definitive treatment in the majority of patients. Patients refractory to a 3- to 4-session ESWT cycle have lower chances of positive response after further ESWT cycles.

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Conflict of interest

The authors, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. The authors state that they have full control of all primary data and that they agree to allow the journal to review their data if requested.

Ethical standard

The IRB and Regional Ethical Committee were made aware of this work and of the submission of our data for publication, and gave formal approval. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedics and Traumatology, School of Medicine, University of Genova, Padiglione 40, Largo Rosanna Benzi 10, 10132, Genoa, Italy

      R. Trentini, T. Mangano, I. Repetto, P. Cerruti, E. Kuqi & F. Franchin

    2. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, School of Medicine, University of Genova, Genoa, Italy

      C. Trompetto

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    1. R. Trentini
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    Correspondence to T. Mangano.

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    R. Trentini and T. Mangano have equally contributed to this work.

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    Trentini, R., Mangano, T., Repetto, I. et al. Short- to mid-term follow-up effectiveness of US-guided focal extracorporeal shock wave therapy in the treatment of elbow lateral epicondylitis. Musculoskelet Surg 99 (Suppl 1), 91–97 (2015). https://doi.org/10.1007/s12306-015-0361-4

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