Renée Keijsers1, Michel P J van den Bekerom2, Koen L M Koenraadt3, Ronald L A W Bleys4, C Niek van Dijk5, Denise Eygendaal6. 1. Department of Orthopaedic Surgery, Amphia Hospital, PO Box 90158, 4800 RK, Breda, The Netherlands. reneekeijsers@gmail.com. 2. Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands. 3. Foundation for Orthopaedic Research, Care and Education, Amphia Hospital, Breda, The Netherlands. 4. Department of Anatomy, UMC, Utrecht, The Netherlands. 5. Department of Orthopaedic Surgery, AMC, Amsterdam, The Netherlands. 6. Department of Orthopaedic Surgery, Amphia Hospital, PO Box 90158, 4800 RK, Breda, The Netherlands.
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.
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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