| Autor: |
Shomal Zadeh, Firoozeh, Shafiei, Mehrzad, Shomalzadeh, Mostafa, Pierce, Jennifer, Thurlow, Peter Christian, Chalian, Majid |
| Předmět: |
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| Zdroj: |
European Radiology; Oct2023, Vol. 33 Issue 10, p7303-7320, 18p, 1 Black and White Photograph, 1 Diagram, 6 Charts, 3 Graphs |
| Abstrakt: |
Objectives: To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy. Methods: A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fasciotomy, ultrasound-guided, and percutaneous. Inclusion criteria consisted of original studies evaluating pain or function improvement after PUNT. Meta-analyses investigating standard mean differences were performed to assess the pain and function improvement. Results: Thirty-five studies with 1674 participants (1876 tendons) were enrolled in this article. Of which 29 articles were included in meta-analysis and the remaining 9 articles without enough numeric data were included in descriptive analysis. PUNT significantly alleviated pain with the standard mean difference of 2.5 (95% CI: 2.0–3.0; p < 0.05), 2.2 (95% confidence interval (CI): 1.8–2.7; p < 0.05), and 3.6 (95% CI: 2.8–4.5; p < 0.05) points in short-term, intermediate-term, and long-term follow-up intervals, respectively. It was also associated with marked improvement in function with 1.4 (95% CI: 1.1–1.8; p < 0.05), 1.8 (95% CI: 1.3–2.2; p < 0.05), and 2.1 (95% CI: 1.6–2.6; p < 0.05) points, respectively in short-term, intermediate-term, and long-term follow-ups. Conclusion: PUNT improved pain and function at short-term intervals with persistent results on intermediate- and long-term follow-ups. PUNT can be considered an appropriate minimally invasive treatment for chronic tendinopathy with a low rate of complications and failures. Clinical relevance: Tendinopathy and fasciopathy are two common musculoskeletal complaints that can cause prolonged pain and disability. PUNT as a treatment option could improve pain intensity and function. Key Points: • The best improvement in pain and function was achieved after the first 3 months following PUNT and was continued to the intermediate- and long-term follow-ups. • No significant difference was found between different tenotomy methods in terms of pain and function improvement. • PUNT is a minimally invasive procedure with promising results and low complication rates for treatments of chronic tendinopathy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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