New Treatment for Lateral Tendinosis

Tennis elbow, also known as tendinitis, has been renamed tendinosis. Studies show there may have been an inflammatory response at one time, but it was disrupted. Instead, an overgrowth of immature blood cells and fibrous cells developed at the elbow.

Either side of the elbow can be affected. The outside or lateral elbow is involved most often. Tendinosis can occur any time the elbow is exposed to stress and overuse.

There are a wide variety of treatments used for tendinosis. Many patients get better with conservative care. This may include rest, antiinflammatories, cold, and splinting. A physical or occupational therapist may use ultrasound, friction massage, and stretching exercises.

Many times the symptoms come back as soon as the patient uses the elbow again. A new treatment may be on the horizon to help. Surgeons from the Cedars-Sinai Medical Center in California tested a new elbow brace for this condition. The ForeArmed Active implant is an energy dampening active implant elbow brace.

The brace puts pressure on two of the tendons involved (extensor carpi radialis brevis and extensor digitorum communis). The brace also provides shock absorption on both sides of the elbow.

Two groups of patients were compared. Group A wore the implant brace anytime they were physically active for more than one hour. They were allowed to use cold compresses and antiinflammatories as needed. Group B was treated with the standard nonoperative care. This included rest, antiinflammatories, cold compresses, and advice.

Results were measured by pain levels and grip strength. Frequency and severity of pain was recorded while at rest, with resisted wrist extension, and when the wrist and elbow were passively moved into an extended position.

Group A had much better results than group B. Grip strength increased 40.6 per cent in group A compared with 28.4 per cent in group B. A few patients in group A required additional treatment besides just the brace. Combining the brace with a cortisone injection or hand therapy gave good results for those individuals. Three patients in Group A ended up having surgery.

Only seven patients in group B had improved symptoms. Half of this group required additional treatment such as cortisone injections, hand therapy, or surgery.

The authors conclude that the implant brace dampens energy forces coming into the elbow. By reducing the energy wave to the tendon insertion site, the impact of the vibrating energy is less. The brace can be worn to prevent or treat lateral tendinosis. It is easy to use and low cost.

References: Joubin S. Gabbay, MD, et al. Use of a Novel Active Implant Enhanced Forearm Device in the Treatment of Lateral Tendinosis. In Orthopedics. December 2007. Vol. 30. No. 12. Pp. 1005-1009.