Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis
Objectives To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy. Methods A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fascio...
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| Veröffentlicht in: | European radiology 2023-10, Vol.33 (10), p.7303-7320 |
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| creator | Shomal Zadeh, Firoozeh Shafiei, Mehrzad Shomalzadeh, Mostafa Pierce, Jennifer Thurlow, Peter Christian Chalian, Majid |
| description | Objectives
To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy.
Methods
A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fasciotomy, ultrasound-guided, and percutaneous. Inclusion criteria consisted of original studies evaluating pain or function improvement after PUNT. Meta-analyses investigating standard mean differences were performed to assess the pain and function improvement.
Results
Thirty-five studies with 1674 participants (1876 tendons) were enrolled in this article. Of which 29 articles were included in meta-analysis and the remaining 9 articles without enough numeric data were included in descriptive analysis. PUNT significantly alleviated pain with the standard mean difference of 2.5 (95% CI: 2.0–3.0;
p
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| doi_str_mv | 10.1007/s00330-023-09657-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2810919277</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2866634488</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-691c06b4c7d8ff53a302b20d4abc5167357f9821e31a2e4d7cd59f0e8ff356dc3</originalsourceid><addsrcrecordid>eNp9kU1PFTEUhhsjEUT_gAvTxA2bSr9mOsPOEBASEljouultT2HITHvtx-L-e3odUOLCVduc57zt6YPQJ0a_MkrVaaZUCEooF4SOfacIf4OOmBScMDrIt6_2h-h9zo-U0pFJ9Q4dCsXkIOR4hOodJFuLCRBrxnUuyeRYgyP3dXLgcABwM-ACIZa47LCPCZcEpiwQCo4e24cUw2T3hJtC3JrysMMmOOxNttN6PsMGL1AMMcHMuzzlD-jAmznDx-f1GP28vPhxfkVubr9fn3-7IVaorpB-ZJb2G2mVG7zvhBGUbzh10mxsx3olOuXHgTMQzHCQTlnXjZ5Cg0XXOyuO0cmau03xV4Vc9DJlC_O8zqv5wNqXjFyphn75B32MNbX37qm-74WUw9AovlI2xZwTeL1N02LSTjOq91L0KkU3Kfq3FM1b0-fn6LpZwP1pebHQALECuZXCPaS_d_8n9gkDD5lt</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2866634488</pqid></control><display><type>article</type><title>Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis</title><source>Springer Nature - Complete Springer Journals</source><creator>Shomal Zadeh, Firoozeh ; Shafiei, Mehrzad ; Shomalzadeh, Mostafa ; Pierce, Jennifer ; Thurlow, Peter Christian ; Chalian, Majid</creator><creatorcontrib>Shomal Zadeh, Firoozeh ; Shafiei, Mehrzad ; Shomalzadeh, Mostafa ; Pierce, Jennifer ; Thurlow, Peter Christian ; Chalian, Majid</creatorcontrib><description><![CDATA[Objectives
To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy.
Methods
A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fasciotomy, ultrasound-guided, and percutaneous. Inclusion criteria consisted of original studies evaluating pain or function improvement after PUNT. Meta-analyses investigating standard mean differences were performed to assess the pain and function improvement.
Results
Thirty-five studies with 1674 participants (1876 tendons) were enrolled in this article. Of which 29 articles were included in meta-analysis and the remaining 9 articles without enough numeric data were included in descriptive analysis. PUNT significantly alleviated pain with the standard mean difference of 2.5 (95% CI: 2.0–3.0;
p
< 0.05), 2.2 (95% confidence interval (CI): 1.8–2.7;
p
< 0.05), and 3.6 (95% CI: 2.8–4.5;
p
< 0.05) points in short-term, intermediate-term, and long-term follow-up intervals, respectively. It was also associated with marked improvement in function with 1.4 (95% CI: 1.1–1.8;
p
< 0.05), 1.8 (95% CI: 1.3–2.2;
p
< 0.05), and 2.1 (95% CI: 1.6–2.6;
p
< 0.05) points, respectively in short-term, intermediate-term, and long-term follow-ups.
Conclusion
PUNT improved pain and function at short-term intervals with persistent results on intermediate- and long-term follow-ups. PUNT can be considered an appropriate minimally invasive treatment for chronic tendinopathy with a low rate of complications and failures.
Clinical relevance
Tendinopathy and fasciopathy are two common musculoskeletal complaints that can cause prolonged pain and disability. PUNT as a treatment option could improve pain intensity and function.
Key Points
•
The best improvement in pain and function was achieved after the first 3 months following PUNT and was continued to the intermediate- and long-term follow-ups.
•
No significant difference was found between different tenotomy methods in terms of pain and function improvement.
•
PUNT is a minimally invasive procedure with promising results and low complication rates for treatments of chronic tendinopathy.]]></description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-09657-2</identifier><identifier>PMID: 37148349</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Complications ; Diagnostic Radiology ; Imaging ; Internal Medicine ; Interventional Radiology ; Medicine ; Medicine & Public Health ; Meta-analysis ; Musculoskeletal ; Neuroradiology ; Pain ; Radiology ; Tendons ; Ultrasonic imaging ; Ultrasound</subject><ispartof>European radiology, 2023-10, Vol.33 (10), p.7303-7320</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2023. corrected publication 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-691c06b4c7d8ff53a302b20d4abc5167357f9821e31a2e4d7cd59f0e8ff356dc3</citedby><cites>FETCH-LOGICAL-c375t-691c06b4c7d8ff53a302b20d4abc5167357f9821e31a2e4d7cd59f0e8ff356dc3</cites><orcidid>0000-0001-8400-1593</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-023-09657-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-023-09657-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37148349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shomal Zadeh, Firoozeh</creatorcontrib><creatorcontrib>Shafiei, Mehrzad</creatorcontrib><creatorcontrib>Shomalzadeh, Mostafa</creatorcontrib><creatorcontrib>Pierce, Jennifer</creatorcontrib><creatorcontrib>Thurlow, Peter Christian</creatorcontrib><creatorcontrib>Chalian, Majid</creatorcontrib><title>Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description><![CDATA[Objectives
To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy.
Methods
A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fasciotomy, ultrasound-guided, and percutaneous. Inclusion criteria consisted of original studies evaluating pain or function improvement after PUNT. Meta-analyses investigating standard mean differences were performed to assess the pain and function improvement.
Results
Thirty-five studies with 1674 participants (1876 tendons) were enrolled in this article. Of which 29 articles were included in meta-analysis and the remaining 9 articles without enough numeric data were included in descriptive analysis. PUNT significantly alleviated pain with the standard mean difference of 2.5 (95% CI: 2.0–3.0;
p
< 0.05), 2.2 (95% confidence interval (CI): 1.8–2.7;
p
< 0.05), and 3.6 (95% CI: 2.8–4.5;
p
< 0.05) points in short-term, intermediate-term, and long-term follow-up intervals, respectively. It was also associated with marked improvement in function with 1.4 (95% CI: 1.1–1.8;
p
< 0.05), 1.8 (95% CI: 1.3–2.2;
p
< 0.05), and 2.1 (95% CI: 1.6–2.6;
p
< 0.05) points, respectively in short-term, intermediate-term, and long-term follow-ups.
Conclusion
PUNT improved pain and function at short-term intervals with persistent results on intermediate- and long-term follow-ups. PUNT can be considered an appropriate minimally invasive treatment for chronic tendinopathy with a low rate of complications and failures.
Clinical relevance
Tendinopathy and fasciopathy are two common musculoskeletal complaints that can cause prolonged pain and disability. PUNT as a treatment option could improve pain intensity and function.
Key Points
•
The best improvement in pain and function was achieved after the first 3 months following PUNT and was continued to the intermediate- and long-term follow-ups.
•
No significant difference was found between different tenotomy methods in terms of pain and function improvement.
•
PUNT is a minimally invasive procedure with promising results and low complication rates for treatments of chronic tendinopathy.]]></description><subject>Complications</subject><subject>Diagnostic Radiology</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Musculoskeletal</subject><subject>Neuroradiology</subject><subject>Pain</subject><subject>Radiology</subject><subject>Tendons</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1PFTEUhhsjEUT_gAvTxA2bSr9mOsPOEBASEljouultT2HITHvtx-L-e3odUOLCVduc57zt6YPQJ0a_MkrVaaZUCEooF4SOfacIf4OOmBScMDrIt6_2h-h9zo-U0pFJ9Q4dCsXkIOR4hOodJFuLCRBrxnUuyeRYgyP3dXLgcABwM-ACIZa47LCPCZcEpiwQCo4e24cUw2T3hJtC3JrysMMmOOxNttN6PsMGL1AMMcHMuzzlD-jAmznDx-f1GP28vPhxfkVubr9fn3-7IVaorpB-ZJb2G2mVG7zvhBGUbzh10mxsx3olOuXHgTMQzHCQTlnXjZ5Cg0XXOyuO0cmau03xV4Vc9DJlC_O8zqv5wNqXjFyphn75B32MNbX37qm-74WUw9AovlI2xZwTeL1N02LSTjOq91L0KkU3Kfq3FM1b0-fn6LpZwP1pebHQALECuZXCPaS_d_8n9gkDD5lt</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Shomal Zadeh, Firoozeh</creator><creator>Shafiei, Mehrzad</creator><creator>Shomalzadeh, Mostafa</creator><creator>Pierce, Jennifer</creator><creator>Thurlow, Peter Christian</creator><creator>Chalian, Majid</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8400-1593</orcidid></search><sort><creationdate>20231001</creationdate><title>Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis</title><author>Shomal Zadeh, Firoozeh ; Shafiei, Mehrzad ; Shomalzadeh, Mostafa ; Pierce, Jennifer ; Thurlow, Peter Christian ; Chalian, Majid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-691c06b4c7d8ff53a302b20d4abc5167357f9821e31a2e4d7cd59f0e8ff356dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Complications</topic><topic>Diagnostic Radiology</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Musculoskeletal</topic><topic>Neuroradiology</topic><topic>Pain</topic><topic>Radiology</topic><topic>Tendons</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shomal Zadeh, Firoozeh</creatorcontrib><creatorcontrib>Shafiei, Mehrzad</creatorcontrib><creatorcontrib>Shomalzadeh, Mostafa</creatorcontrib><creatorcontrib>Pierce, Jennifer</creatorcontrib><creatorcontrib>Thurlow, Peter Christian</creatorcontrib><creatorcontrib>Chalian, Majid</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shomal Zadeh, Firoozeh</au><au>Shafiei, Mehrzad</au><au>Shomalzadeh, Mostafa</au><au>Pierce, Jennifer</au><au>Thurlow, Peter Christian</au><au>Chalian, Majid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>33</volume><issue>10</issue><spage>7303</spage><epage>7320</epage><pages>7303-7320</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract><![CDATA[Objectives
To systematically assess the efficacy of percutaneous ultrasound-guided needle tenotomy (PUNT) in the treatment of chronic tendinopathy and fasciopathy.
Methods
A comprehensive literature search was performed with the following search terms: tendinopathy, tenotomy, needling, Tenex, fasciotomy, ultrasound-guided, and percutaneous. Inclusion criteria consisted of original studies evaluating pain or function improvement after PUNT. Meta-analyses investigating standard mean differences were performed to assess the pain and function improvement.
Results
Thirty-five studies with 1674 participants (1876 tendons) were enrolled in this article. Of which 29 articles were included in meta-analysis and the remaining 9 articles without enough numeric data were included in descriptive analysis. PUNT significantly alleviated pain with the standard mean difference of 2.5 (95% CI: 2.0–3.0;
p
< 0.05), 2.2 (95% confidence interval (CI): 1.8–2.7;
p
< 0.05), and 3.6 (95% CI: 2.8–4.5;
p
< 0.05) points in short-term, intermediate-term, and long-term follow-up intervals, respectively. It was also associated with marked improvement in function with 1.4 (95% CI: 1.1–1.8;
p
< 0.05), 1.8 (95% CI: 1.3–2.2;
p
< 0.05), and 2.1 (95% CI: 1.6–2.6;
p
< 0.05) points, respectively in short-term, intermediate-term, and long-term follow-ups.
Conclusion
PUNT improved pain and function at short-term intervals with persistent results on intermediate- and long-term follow-ups. PUNT can be considered an appropriate minimally invasive treatment for chronic tendinopathy with a low rate of complications and failures.
Clinical relevance
Tendinopathy and fasciopathy are two common musculoskeletal complaints that can cause prolonged pain and disability. PUNT as a treatment option could improve pain intensity and function.
Key Points
•
The best improvement in pain and function was achieved after the first 3 months following PUNT and was continued to the intermediate- and long-term follow-ups.
•
No significant difference was found between different tenotomy methods in terms of pain and function improvement.
•
PUNT is a minimally invasive procedure with promising results and low complication rates for treatments of chronic tendinopathy.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37148349</pmid><doi>10.1007/s00330-023-09657-2</doi><tpages>18</tpages><orcidid>https://orcid.org/0000-0001-8400-1593</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2023-10, Vol.33 (10), p.7303-7320 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2810919277 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Complications Diagnostic Radiology Imaging Internal Medicine Interventional Radiology Medicine Medicine & Public Health Meta-analysis Musculoskeletal Neuroradiology Pain Radiology Tendons Ultrasonic imaging Ultrasound |
| title | Percutaneous ultrasound-guided needle tenotomy for treatment of chronic tendinopathy and fasciopathy: a meta-analysis |
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