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Effect of Repetitive Corticosteroid Injection on Tennis Elbow Surgery

American Journal of Sports Medicine(2023)SCI 1区

CHA Bundang Med Ctr | CHA Univ

Cited 0|Views5
Abstract
Background: Lateral epicondylitis is a chronic tendinopathy of humeral origin of the common extensor tendon. Most patients show improvement after nonoperative treatment. However, 4% to 11% of patients require surgical treatment. Although corticosteroid injection is one of the most commonly applied nonoperative treatment methods, to the authors’ knowledge, no study has reported the effect of the number of preoperative corticosteroid injections on the final postoperative outcome. Thus, the objective of this study was to determine the effect of the number of preoperative corticosteroid injections on postoperative clinical outcomes. Hypothesis: The number of corticosteroid injections before surgical treatment does not affect postoperative clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: As a retrospective review, from January 2007 to December 2019, a total of 99 patients who had undergone surgical treatment of lateral epicondylitis with a modified Nirschl technique were enrolled. The number of preoperative corticosteroid injections was investigated by medical record review. Outcome measurements included visual analog pain scale; Disabilities of the Arm, Shoulder and Hand (DASH) score; Mayo Elbow Performance Score; and the Nirschl and Pettrone grade. Grip power and wrist extension power were measured using a digital dynamometer. Results: A total of 99 patients were included in this study. The mean total number of injections of patients was 4.37 ± 2.46 times (range, 1-15 times). Total duration of nonoperative treatment before surgery was 25.4 ± 20.5 months (range, 4-124.8 months). The mean postoperative follow-up period was 42.8 ± 28.0 months (range, 12-110 months). For all injection numbers, clinical scores showed significant improvement in visual analog pain scale, DASH score, Mayo elbow score, grip power, and wrist extension power after surgery. Regression analysis showed that the degree of improvement according to the injection number was not statistically significant. The Nirschl and Pettrone grade was excellent in 82 (82.8%) patients, good in 14 (14.1%) patients, fair in 2 (2%) patient, and failure in 1 (1%) patient. Conclusion: The number of preoperative corticosteroid injections does not appear to affect postoperative clinical outcomes of patients with lateral epicondylitis who undergo surgery with a modified Nirschl technique.
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Key words
lateral epicondylitis,corticosteroid injection,modified Nirschl technique,surgical outcome,extensor carpi radialis brevis,muscle strength
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要点】:本研究探讨了术前皮质类固醇注射次数对采用改良Nirschl技术治疗的网球肘术后临床结果的影响,发现注射次数对术后结果无显著影响。

方法】:通过回顾性分析2007年至2019年间接受改良Nirschl技术手术治疗的99名网球肘患者的医疗记录,研究术前皮质类固醇注射次数与术后临床结果的关系。

实验】:本研究收集了患者的视觉模拟疼痛评分、手臂、肩部和手部功能障碍评分(DASH)、Mayo肘部表现评分、Nirschl和Pettrone等级,以及握力和腕部伸展力等数据,并对这些数据进行了回归分析,发现不同注射次数的改善程度没有统计学上的显著性差异。数据集来源于患者的医疗记录。