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

Wataru Iwamoto, Yuji Okuno, Noboru Matsumura, Takao Kaneko, Hiroyasu Ikegami

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Abnormal vessels and accompanying nerves are possible sources of pain with lateral epicondylitis. The purpose of this study was to describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis resistant to conservative treatment. Methods This prospective study was conducted in 24 patients with lateral epicondylitis resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2014. Two patients were lost to follow-up, and the remaining 22 patients were followed up for 2 years after TAE. Results Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disabilities of the Arm, Shoulder and Hand scores at baseline significantly decreased at 1, 3, 6, and 24 months after treatment (50.8 vs 23.4, 8.3, 5.3, and 2.7, respectively; all P <.001). There was a statistically significant (P <.001) change from baseline to the last observed value in all of the clinical parameters, including visual analog scale pain score, Patient-Rated Tennis Elbow Evaluation score, and pain-free grip strength. Magnetic resonance images obtained 2 years after TAE showed an improvement in tendinosis and tear scores compared with baseline, and no patients showed bone marrow necrosis, obvious cartilage loss, or muscle atrophy. Conclusion TAE could be one possible treatment option for patients with lateral epicondylitis that fails to improve with conservative treatments.

Original languageEnglish
Pages (from-to)1335-1341
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number8
DOIs
Publication statusPublished - 2017 Aug 1

Fingerprint

Tennis Elbow
Therapeutics
Pain
Tendinopathy
Osteonecrosis
Muscular Atrophy
Lost to Follow-Up
Hand Strength
Pain Measurement
Conservative Treatment
Tears
Cartilage
Arm
Magnetic Resonance Spectroscopy
Hand
Bone Marrow
Prospective Studies
Safety

Keywords

  • abnormal vessels
  • Elbow pain
  • embolization
  • lateral epicondylitis
  • magnetic resonance imaging score
  • resistant cases

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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. / Iwamoto, Wataru; Okuno, Yuji; Matsumura, Noboru; Kaneko, Takao; Ikegami, Hiroyasu.

In: Journal of Shoulder and Elbow Surgery, Vol. 26, No. 8, 01.08.2017, p. 1335-1341.

Research output: Contribution to journalArticle

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abstract = "Background Abnormal vessels and accompanying nerves are possible sources of pain with lateral epicondylitis. The purpose of this study was to describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis resistant to conservative treatment. Methods This prospective study was conducted in 24 patients with lateral epicondylitis resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2014. Two patients were lost to follow-up, and the remaining 22 patients were followed up for 2 years after TAE. Results Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disabilities of the Arm, Shoulder and Hand scores at baseline significantly decreased at 1, 3, 6, and 24 months after treatment (50.8 vs 23.4, 8.3, 5.3, and 2.7, respectively; all P <.001). There was a statistically significant (P <.001) change from baseline to the last observed value in all of the clinical parameters, including visual analog scale pain score, Patient-Rated Tennis Elbow Evaluation score, and pain-free grip strength. Magnetic resonance images obtained 2 years after TAE showed an improvement in tendinosis and tear scores compared with baseline, and no patients showed bone marrow necrosis, obvious cartilage loss, or muscle atrophy. Conclusion TAE could be one possible treatment option for patients with lateral epicondylitis that fails to improve with conservative treatments.",
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