C0071 Ultrasound-guided invasive treatment with epte® in the lateral epicondyle tendinopathy. A case report

Abstract

Background Insertional tendinopathy from the wrist extensors, is a very common pathology. Biomechanical, structural and sensitivity factors intervene in its onset. At present, electrolysis based on microcurrent application (EPTE) becomes an increasingly used tool for tendinopathies due to its high effectiveness in pain decrease and function improvement. Percutaneous electrolysis produces a ‘lysis’ phenomenon targeted at the degenerated tissue producing debris substances such as sodium hydroxide and hydrogen. In animal models, some metabolic effects have been observed, reducing the presence of substances that have the role of degradation of the extracellular matrix.

Methods 51 year old-female, sedentary worker with no sportive practice, present lateral epicondyle pain from 8 months. Medical ultrasound diagnosis of lateral epicondyle tendinopathy. Allodynia appears in lateral part of affected albow.

Intervention 4 EPTE interventions, one per week consecutively, have been performed. Interventions have been ultrasound-guided with Mindray M7 ultrasound. Adjustment parameters used for all cases were 160 microamperes during 160 s, respecting electric charge (Q) values of 25,6 mC. Two approaches were used. First, at 3 milimeters distally form the lateral epicondyle, out of plane, in order to have an impact on the superficial layer of the targeted tendon. Second approach was aimed to neovascularized spots, introducing the needle longitudinally in plane, on the line that describes the extensor carpi radialis brevis. In combination, patients were recommended to practice isometric exercises at different wrist angles.

Variables The examiner took the variables Visual Analogue Scale (VAS), and the Quick-DASH. These measurements have been recorded in the first evaluation prior to the beginning of treatment, and also before each session. Last measurement was taken 2 weeks later form the last treatment, completing the entire follow-up within 6 weeks.

Results Decrease in pain was observed between first and second intervention, with a sharper diminution in pain values between second and third session. Functionality and allodynia values behaved similarly to pain levels.

Conclusions EPTE® can be considered a useful and reliable therapeutic approach for the treatment of tennis elbow tendinopathies framed in a multifactorial perspective. Despite good results, studies with a larger number of subjects and the establishment of a control group are warranted.