There were 20 patients (13 females and 7 Males) with a median age of 45.5 years (range 33 – 65 years).
The mean duration of failed conservative therapy was 12.5 months (range 4 – 48 months).
The latter included prior steroid injection and acupuncture.
One patient had previously undergone surgical treatment.
At the 36 month follow up,
19 of the 20 subjects were contactable.
The mean VAS score recorded at baseline was 5.4 (range 1 – 8). This showed reduction to 2.0 (range 0 – 5) at the 3 month,
1.2 (range 0 – 3) at the 6 month and 0.3 (range 0 – 3) at the 36 month evaluation.
The mean DASH score recorded at baseline was 27.8 (range 5 – 54.2).
This showed reduction to 12.3 (range 0 – 41.7) at the 3 month,
7.8 (range 0 – 40.8) at the 6 month and 0.4 (range 0 – 1.7) at the 36 month evaluation.
The mean tendon thickness recorded at baseline was 5.4 mm (range 4.3 – 6.5).
This showed reduction to 5.3 mm (range 3.6 – 7.1) at the 3 month,
4.6 mm (range 3.5 – 5.9) at the 6 month and 3.7 mm (range 3.1 – 5.1) at the 36 month evaluation.
The mean score for hypoechoic area within the tendon recorded at baseline was 2.4 (range 2 -3).
This showed reduction to 2.1 (range 1 – 3) at the 3 month,
1.3 (range 1 – 2) at the 6 month and 1.1 (range 1 – 2) at the 36 month evaluation.
The mean score for hypervascularity within the tendon recorded at baseline was 1.4 (range 0 - 3).
This showed reduction to 1.1 (range 0 – 3) at the 3 month,
0.5 (range 0 – 2) at the 6 month and 0.1 (range 0 - 1) at the 36 month evaluation.
The mean score for paratenon vascularity recorded at baseline was 1.0 (range 0 - 2).
This showed reduction to 0.5 (range 0 – 2) at the 3 month,
0.2 (range 0 –1) at the 6 month and 0 at the 36 month evaluation.
In summary,
the thickness of tendon showed reduction from a mean of 5.4 mm to 3.7 mm (p<0.001).
Reduction in hypoechoic area (mean score of 2.4 to 1.1 [p<0.001]),
reduction in hypervascularity of the tendon (mean score of 1.4 to 0.1 [p<0.001]) and complete resolution of neovascularity of the paratenon (mean score of 1.0 to 0 [p<0.001]) were observed.
The trends in mean VAS and DASH were compared with the parameters recorded on ultrasound.
Graphical representation can be seen in Fig. 8 and Fig. 9 respectively.
The observed sonographic changes in one patient are depicted in Fig. 10.