Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results

Abstract

BackgroundUltrasound (US)-guided percutaneous needle electrolysis (PNE) is a novel minimally invasive approach which consists of the application of a galvanic current through an acupuncture needle.ObjectiveTo evaluate the clinical and ultrasonographic effectiveness of a multimodal programme (PNE, eccentric exercise (EccEx) and stretching) in the short term for patients with chronic lateral epicondylitis, and to determine whether the clinical outcomes achieved decline over time.MethodsA one-way repeated measures study was performed in a clinical setting in 36 patients presenting with lateral epicondylitis. The patients received one session of US-guided PNE per week over 4–6 weeks, associated with a home programme of EccEx and stretching. The main outcome measures were severity of pain, disability (Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), structural tendon changes (US), hypervascularity and patients’ perceptions of overall outcome. Measurements at 6, 26 and 52 weeks follow-up included recurrence rates (increase in severity of pain or disability compared with discharge), perception of overall outcome and success rates.ResultsAll outcome measures registered significant improvements between pre-intervention and discharge. Most patients (n=30, 83.3%) rated the overall outcome as ‘successful’ at 6 weeks. The ultrasonographic findings showed that the hypoechoic regions and hypervascularity of the extensor carpi radialis brevis changed significantly. At 26 and 52 weeks, all participants (n=32) perceived a ‘successful’ outcome. Recurrence rates were null after discharge and at follow-up at 6, 26 and 52 weeks.ConclusionsSymptoms and degenerative structural changes of chronic lateral epicondylitis are reduced after US-guided PNE associated with EccEx and stretching, with encouragingly low recurrences in the mid to long term.Trial registration numberClinicalTrials.gov identifier: NCT02085928.

Treatment of Sport Injuries With Acupuncture: A Literature Review

“…36,37 A study prepared by Magra using NSAIDs to treat this type of injury observed small or no reduction of pain, 38 whereas his 2005 meta-analysis demonstrated that acupuncture causes significant short-term pain relief in lateral epicondylitis. 36 The research on the clinical trials selected for this review have presented positive results for acupuncture treatment, being such results more favorable when acupuncture is associated with another type of therapy 26,27 and when applied by a physician rather than being self-administered 25 .…”

“…Thirty-two of 36 patients were located for reevaluation after 26 and 52 weeks, with a 100% perception of success. 26 In 2016, Yang et al published a clinical trial on six Korean medical doctors who worked as the Korean women's volleyball team physicians between 2013 and 2014. The physicians recorded the injuries suffered by each athlete, the type of treatment used, and whether additional therapy combined with Western medicine was required.…”

Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application

“…The galvanic current in a saline solution rapidly develops the chemical process of electrolysis, which in turn in-duces tissue ablation 11 . The EPI technique finds indications in the treatment of tendinopathies and fibrosis [12][13][14][15][16] . The rationale for using EPI in the treatment of PH-TrSNE is the ability of the technique to specifically degrade fibrotic adhesions that bind the SN and SM tendon.…”

“…To date however, few studies have tested the effectiveness of the technique. The therapeutic utility of EPI (by some Authors replaced with the acronym PNE, Percutaneous Needle Electrolysis) was tested for the treatment of patellar tendinopathy 12,13 , sub-acromial syndrome 14 , chronic lateral epicondylitis 15 and rectus abdominisrelated groin pain 16 . The clinical results presented in this work are somewhat in conflict, especially given the different methodological choices of the Authors, in particular relative to the intensity and duration of administration of the galvanic current (which varied from 0.3 mA for 1.2 minutes to 3 mA for a few seconds) and suggested physiotherapy administered in combination with the technique.…”

Treatment of proximal hamstring tendinopathyrelated sciatic nerve entrapment: presentation of an ultrasound-guided �Intratissue Percutaneous Electrolysis� application

“…The galvanic current in a saline solution rapidly develops the chemical process of electrolysis, which in turn induces tissue ablation 11 . The EPI technique finds indications in the treatment of tendinopathies and fibrosis [12][13][14][15][16] . The rationale for using EPI in the treatment of PHTrSNE is the ability of the technique to specifically degrade fibrotic adhesions that bind the SN and SM tendon.…”