Common tendinopathies around the elbow

Q4 Medicine Orthopaedics and Trauma Pub Date : 2024-08-01 DOI:10.1016/j.mporth.2024.05.001
Parag Raval, Victoria Gibbs, Jenna Shepherd, Radhakant Pandey
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Abstract

There are a number of factors that can contribute to the exacerbation of tendinopathies around the elbow. In order to effectively manage patients, it is important to understand the natural progression of these conditions, injury mechanisms, potential risk factors and the range of pathological manifestations. Presently, disease-modifying treatments for tendinopathy are lacking, placing non-operative approaches, staged physiotherapy and support at the forefront of primary options. Conservative management proves successful for medial and lateral epicondylitis, though some cases may require up to a year for improvement. Short-term relief can be achieved with non-steroidal anti-inflammatory drugs and corticosteroid injections, although their long-term efficacy is uncertain, and evidence for alternative injection therapies is limited. Surgical intervention can be considered if non-operative management proves ineffective after 6–12 months, often involving open resection, debridement, and repair. While arthroscopic techniques offer promise, they present inherent risks, particularly in patients with prior surgeries. Despite the rarity of distal triceps and biceps tendinopathies, prompt diagnosis and non-operative approaches are pivotal, with surgery considered if symptoms persist after 6 months. Overall, favourable outcomes can be achieved for common elbow tendinopathies with control of risk factors and appropriate care.

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常见的肘部肌腱疾病
导致肘关节周围肌腱病恶化的因素有很多。为了有效管理患者,了解这些疾病的自然发展过程、损伤机制、潜在风险因素和病理表现的范围非常重要。目前,针对腱鞘病变的疾病调节疗法尚缺乏,因此非手术疗法、分阶段理疗和支持疗法成为首要选择。保守治疗对内侧和外侧上髁炎疗效显著,但有些病例可能需要长达一年的时间才能好转。非甾体类抗炎药和皮质类固醇注射可在短期内缓解症状,但其长期疗效尚不确定,替代注射疗法的证据也很有限。如果 6-12 个月后非手术治疗无效,可考虑手术干预,通常包括开放性切除、清创和修复。虽然关节镜技术前景广阔,但也存在固有风险,尤其是对曾接受过手术的患者而言。尽管肱三头肌和肱二头肌远端肌腱病非常罕见,但及时诊断和非手术疗法至关重要,如果症状在 6 个月后仍然存在,则应考虑手术治疗。总体而言,通过控制风险因素和适当的护理,常见的肘部肌腱病可以获得良好的治疗效果。
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来源期刊
Orthopaedics and Trauma
Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine
CiteScore
1.00
自引率
0.00%
发文量
57
期刊介绍: Orthopaedics and Trauma presents a unique collection of International review articles summarizing the current state of knowledge and research in orthopaedics. Each issue focuses on a specific topic, discussed in depth in a mini-symposium; other articles cover the areas of basic science, medicine, children/adults, trauma, imaging and historical review. There is also an annotation, self-assessment questions and a second opinion section. In this way the entire postgraduate syllabus will be covered in a 4-year cycle.
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