Abstract
Introduction
Tennis and Golfers elbows (TE, GE) are difficult conditions to treat. Ultrasound guided steroid injection (UGSI) is one of the treatment modalities in treating refractory TE and GE. We present our clinical experience and short to mid-term results of patients with TE and GE treated with UGSI.
Methods
Patients with persistent TE and GE treated with UGSI (Marcaine and kenalog) at a tertiary centre between 2007 and 2010 were retrospectively reviewed. Mean follow up was 4 months (Range 2–21 months). Patients were assessed for pain relief, recurrence of symptoms and surgical release.
Results
USGI was performed on 181 elbows (144 patients). There were 68 male and 76 female patients. Mean age 49.5 years (range 17–82).
At the time of UGSI, chronic features of TE were established in 144 elbows and signs of GE were identified in 37 elbows.
At the review clinic, 155 (86%) elbows were reported to be completely pain free, 10 (5%) elbows experienced no improvement and 16 (9%) elbows encountered residual symptoms.
However, a total of 98 (54%) elbows experienced recurrence of symptoms. For TE, symptoms recurred in 74/144 (51%) elbows at a mean interval of 5.8 months (95% CI: 4.6 to 6.9 months). For GE, symptoms recurred in 24/37 (64%) elbows at a mean interval of 4.2 months (95% CI: 3.4 to 5.0 months).
Repeat USGI was performed in 24 elbows, of which 20 elbows were associated with further recurrence. Fifty seven (50%) elbows underwent surgical release (45 TE and 12 GE).
Discussion
USGI appears to be a beneficial short term measure in controlling the symptoms of TE and GE. However, recurrence or failure to improve occurred in 68% of elbows. Repeat USGI is associated with high failure rate (83%) and surgical option should be explored in these refractory conditions.
