A new non-invasive day treatment for tennis elbow speeds healing. Singapore General Hospital (SGH) Department of Orthopaedic Surgery explains.
It’s called tennis elbow. But it isn’t just the elbow that is affected, nor is it only caused by playing tennis.
Tennis elbow, or tendinitis, is a painful condition that occurs when the tendon – the structure that joins the muscle to the bone, allowing the joint to move – in the elbow (or any other part of the body) is overworked, usually by repeated motions in the wrist and arm. So it is a problem for people who repeatedly strain their elbows, like administrators who use a computer mouse or carry heavy files, housewives and chefs. It is also likely to be a problem for someone who is middle- aged rather than the young or the very old.
When tendinitis is diagnosed, treatment can include rest and anti-inflammatory medications in the initial stages, physical therapy such as hot and/or cold compresses and exercises, steroid and anaesthetic injections, or blood products, as well as surgery when the disease is advanced.
First ultrasound treatment for tendinitis in Asia-Pacific
In August 2012, a new and quicker treatment became available at the Singapore General Hospital (SGH): it is a non-invasive day-surgery treatment that results in faster recovery, and is the first such procedure available in the Asia-Pacific region.
“The SGH sees about 20 to 30 patients with tennis elbow every month, and we understand how frustrating it can be for patients when their conditions do not improve after non-surgical therapies,” said Dr Joyce Koh, Senior Consultant,
Department of Orthopaedic Surgery, Singapore General Hospital (SGH), a member of the
“The procedure provides patients who are hesitant or fearful of surgery with another treatment option, as it is performed in an outpatient clinic setting.”
Known as a percutaneous ultrasonic tenotomy, the procedure is performed under local anaesthesia and involves using ultrasound and a toothpick-sized probe to treat the damaged tendon tissue.
Using ultrasound imaging, the location of the damaged tendon tissue is identified and the probe is inserted through the skin into the area. Ultrasonic energy then cuts, breaks up and removes the damaged tissue, sparing the surrounding healthy tendon tissue. No sutures or stitches are needed when the procedure is completed, and only a sterile adhesive bandage is used to cover the wound. The patient is discharged on the same day.
Patients who undergo the procedure typically take about a week to heal from the wound, although Dr Koh advises staying off stressful activities for at least six weeks for internal tissues to heal and to build up. With more conventional forms of surgery, patients may need two weeks to recuperate before the surgical stitches are removed, and several more weeks before they can return to work. Most conventional surgeries are also done under general anaesthesia, with its related risks and complications.
More details on the novel treatment in the next page.