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Injection of tennis elbow: Hit and miss? A cadaveric study of injection accuracy

  • Elbow
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Different injection therapies are used in the treatment of lateral epicondylitis (LE). Usually, the extensor carpi radialis brevis (ECRB) tendon is affected. Therefore, an injection should be aimed at the origin of this tendon. This study demonstrates the accuracy of manual injections in the treatment of LE.

Methods

Ten surgeons have injected a cadaver elbow with acrylic paint, using the same injection technique (i.e. number of perforations, amount of injected fluid) that they in daily practice would use in the treatment of LE. After the injection, an arthroscopy and dissection of the elbow were performed. The injection technique and localization of acrylic paint were reported.

Results

Only a third of the injections were (partially) localized in the ECRB tendon; 60 % were localized intra-articular.

Conclusion

Injections carried out manually for the treatment of LE are not accurate, resulting in the majority being localized intra-articular. For future research to the effect of injection therapy in the treatment of LE, it is important that injections should be performed in a reproducible and standardized way.

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Acknowledgments

The authors would like to acknowledge the contribution of the Department of Anatomy, UMC, Utrecht, and the Arthroscopy and Arthroplasty course, and thank them for giving us the opportunity to execute this study. In addition, we would like to thank the collaborators of this study.

Elbow Study Collaborative

Roger van Riet, Bart Middernacht, Saartje Defoort, Marc Wagener, Ramzi Haraké, Jean-Florin Ciornohac, Robert Montarnal, Yasmin van Benthem, Stefano Cattaneo, Dirk Faber, Leesa Galatz, Illugi Birkisson, Henk van der Hoeven, Suzanne Witjes, M. Heeren, El-gammal Ahmed, Husif, Annechien Beumer, Bertram The.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Amphia Hospital, PO Box 90158, 4800 RK, Breda, The Netherlands

    Renée Keijsers & Denise Eygendaal

  2. Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands

    Michel P. J. van den Bekerom

  3. Foundation for Orthopaedic Research, Care and Education, Amphia Hospital, Breda, The Netherlands

    Koen L. M. Koenraadt

  4. Department of Anatomy, UMC, Utrecht, The Netherlands

    Ronald L. A. W. Bleys

  5. Department of Orthopaedic Surgery, AMC, Amsterdam, The Netherlands

    C. Niek van Dijk

Authors
  1. Renée Keijsers
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  2. Michel P. J. van den Bekerom
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  3. Koen L. M. Koenraadt
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  4. Ronald L. A. W. Bleys
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  5. C. Niek van Dijk
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  6. Denise Eygendaal
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Consortia

Elbow Study Collaborative

  • Roger van Riet
  • , Bart Middernacht
  • , Saartje Defoort
  • , Marc Wagener
  • , Ramzi Haraké
  • , Jean-Florin Ciornohac
  • , Robert Montarnal
  • , Yasmin van Benthem
  • , Stefano Cattaneo
  • , Dirk Faber
  • , Leesa Galatz
  • , Illugi Birkisson
  • , Henk van der Hoeven
  • , Suzanne Witjes
  • , M. Heeren
  • , El-gammal Ahmed
  • ,  Husif
  • , Annechien Beumer
  •  & Bertram The

Corresponding author

Correspondence to Renée Keijsers.

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Keijsers, R., van den Bekerom, M.P.J., Koenraadt, K.L.M. et al. Injection of tennis elbow: Hit and miss? A cadaveric study of injection accuracy. Knee Surg Sports Traumatol Arthrosc 25, 2289–2292 (2017). https://doi.org/10.1007/s00167-016-4212-0

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  • DOI: https://doi.org/10.1007/s00167-016-4212-0

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