Ultrasonic Percutaneous Tenotomy for Recalcitrant XXXX : Sustainability and Sonographic Progression at 3 Years.

@entity1 @entity3145 @entity2318 @entity924 @entity2633 @entity158
BACKGROUND: A previously published study found positive outcomes for a novel technique for ultrasound-guided percutaneous ultrasonic tenotomy, showing good tolerability, safety, and early efficacy within an office setting. PURPOSE: In this follow-up study, all 20 members of the original cohort were contacted after 3 years to explore the sustainability of symptomatic relief, functional improvement, and sonographic soft tissue response for percutaneous ultrasonic tenotomy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All 20 subjects of the clinical trial that was performed from June to November 2011 were further assessed at 36 months after the procedure in terms of visual analog scale for @entity158 , Disabilities of the Arm, Shoulder and Hand (DASH)-Compulsory/Work scores, need for adjunct procedures, and overall satisfaction. Importantly, all 20 were reassessed with ultrasound imaging at 36 months, and evidence of the common extensor tendon response was assessed in terms of @entity924 , tendon thickness, and the progress of the @entity3145 . RESULTS: A 100% clinical follow-up was achieved, inclusive of ultrasonographic assessment. None of the subjects required further treatment procedures, and 100% expressed satisfaction. Previous improvements in visual analog scale (current median    SD, 0    0.9; range, 0-3) and DASH-Work scores (current median, 0    0) were sustained with conformity to a linear pattern on polynomial measures. There was further reduction in DASH-Compulsory scores to a median of 0    0.644 (range, 0-2) with a significant decrease on repeated measures (P = .008). Tendon hypervascularity was resolved in 94% of @entity1 , and 100% had @entity924 . Overall reduction in the @entity3145 was observed in all subjects, with a 90% response achieved by 6 months. Between 6 and 36 months, further @entity2318 was observed in around 60% of @entity1 , with 20% of @entity1 having complete resolution of the @entity2318 . CONCLUSION: Minimally invasive percutaneous ultrasonic tenotomy provided sustained @entity158 relief and functional improvement for recalcitrant @entity2633 elbow at 3-year follow-up. It is one of the few procedures to demonstrate positive sonographic evidence of tissue-healing response and is an attractive alternative to surgical intervention for definitive treatment of @entity924 .
