Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy
[EN]Distal biceps brachii tendinopathy is a musculoskeletal pain condition—comprising chronic intrasubstance degeneration with alterations of the tendon structure—that is difficult to treat. Preliminary evidence suggests a positive effect for pain and related disability of percutaneous electrolysis...
| Authors: | ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2022 |
| Country: | España |
| Institution: | Universidad de Salamanca (USAL) |
| Repository: | GREDOS. Repositorio Institucional de la Universidad de Salamanca |
| OAI Identifier: | oai:gredos.usal.es:10366/169337 |
| Online Access: | http://hdl.handle.net/10366/169337 |
| Access Level: | Open access |
| Keyword: | Distal biceps brachii tendon Cadaver Brachial artery Tendinopathy Percutaneous electrolysis Brachial Artery Electrolysis arteria braquial cadáver tendinopatía electrolisis |
| _version_ | 1878737717400961025 |
|---|---|
| author | Calderón Díez, Laura |
| author2 | Sánchez Sánchez, José Luis Belón-Pérez, Pedro Robles García, Miguel Pérez Robledo, Fátima Fernández de las Peñas, César |
| author2_role | author author author author author |
| author_browse | Belón-Pérez, Pedro Calderón Díez, Laura Fernández de las Peñas, César Pérez Robledo, Fátima Robles García, Miguel Sánchez Sánchez, José Luis |
| author_facet | Calderón Díez, Laura Sánchez Sánchez, José Luis Belón-Pérez, Pedro Robles García, Miguel Pérez Robledo, Fátima Fernández de las Peñas, César |
| author_role | author |
| collection | GREDOS. Repositorio Institucional de la Universidad de Salamanca |
| description | [EN]Distal biceps brachii tendinopathy is a musculoskeletal pain condition—comprising chronic intrasubstance degeneration with alterations of the tendon structure—that is difficult to treat. Preliminary evidence suggests a positive effect for pain and related disability of percutaneous electrolysis treatment in patients with tendinopathy. Ultrasound is an excellent diagnostic tool to identify tendon injuries, such as tendinopathy, and to guide treatment approaches. Different approaches using ultrasound evaluation of the biceps tendon have been described. Our aim was to determine the validity and safety of a percutaneous electrolysis approach, targeting insertion of the distal tendon of biceps brachii, in both human (ultrasound-guided) and Thiel-embalmed cadaver (not ultrasound-guided) models. There were two approaches evaluated: an anterior approach with the elbow in extension and the forearm in supination and a posterior approach with the elbow in flexion and the forearm in pronation. A needle was inserted following the tendon up to its insertion into the radial tuberosity. The anterior approach, both in cadaveric study and US-guided intervention, revealed a close relationship between the distal biceps tendon and the brachial artery. The mean distance of the depth of the biceps tendon distal to the brachial artery was 0.21 ± 0.021 cm in the cadavers and 0.51 ± 0.024 cm in subjects. It was also found that the anterior approach has a potential technical difficulty due to the anatomical location of the brachial artery. With the posterior approach, it was possible to safely identify the tendon insertion and the needle approach, since no important vascular and nervous structures were visualized in the window of insertion of the needle. The clinician rated the posterior approach as low difficulty in all subjects. Current results would support a posterior approach with US guidance as a safe approach for applying the percutaneous electrolysis technique for insertional tendinopathies of the distal biceps brachii tendon. The current study did not assess the effectiveness of the proposed intervention; accordingly, future studies investigating the clinical effectiveness of the proposed intervention are needed. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_a3dcbef54f4058bcbd3cd1526cdaee7c |
| institution | Universidad de Salamanca (USAL) |
| instname_str | Universidad de Salamanca (USAL) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:gredos.usal.es:10366/169337 |
| publishDate | 2022 |
| publishDateSort | 2022 |
| publisher | MDPI |
| publisherStr | MDPI |
| reponame_str | GREDOS. Repositorio Institucional de la Universidad de Salamanca |
| spelling | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy Calderón Díez, Laura Sánchez Sánchez, José Luis Belón-Pérez, Pedro Robles García, Miguel Pérez Robledo, Fátima Fernández de las Peñas, César Distal biceps brachii tendon Cadaver Brachial artery Tendinopathy Percutaneous electrolysis Brachial Artery Electrolysis arteria braquial cadáver tendinopatía electrolisis [EN]Distal biceps brachii tendinopathy is a musculoskeletal pain condition—comprising chronic intrasubstance degeneration with alterations of the tendon structure—that is difficult to treat. Preliminary evidence suggests a positive effect for pain and related disability of percutaneous electrolysis treatment in patients with tendinopathy. Ultrasound is an excellent diagnostic tool to identify tendon injuries, such as tendinopathy, and to guide treatment approaches. Different approaches using ultrasound evaluation of the biceps tendon have been described. Our aim was to determine the validity and safety of a percutaneous electrolysis approach, targeting insertion of the distal tendon of biceps brachii, in both human (ultrasound-guided) and Thiel-embalmed cadaver (not ultrasound-guided) models. There were two approaches evaluated: an anterior approach with the elbow in extension and the forearm in supination and a posterior approach with the elbow in flexion and the forearm in pronation. A needle was inserted following the tendon up to its insertion into the radial tuberosity. The anterior approach, both in cadaveric study and US-guided intervention, revealed a close relationship between the distal biceps tendon and the brachial artery. The mean distance of the depth of the biceps tendon distal to the brachial artery was 0.21 ± 0.021 cm in the cadavers and 0.51 ± 0.024 cm in subjects. It was also found that the anterior approach has a potential technical difficulty due to the anatomical location of the brachial artery. With the posterior approach, it was possible to safely identify the tendon insertion and the needle approach, since no important vascular and nervous structures were visualized in the window of insertion of the needle. The clinician rated the posterior approach as low difficulty in all subjects. Current results would support a posterior approach with US guidance as a safe approach for applying the percutaneous electrolysis technique for insertional tendinopathies of the distal biceps brachii tendon. The current study did not assess the effectiveness of the proposed intervention; accordingly, future studies investigating the clinical effectiveness of the proposed intervention are needed. MDPI http://hdl.handle.net/10366/169337 |
| spellingShingle | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy Calderón Díez, Laura Distal biceps brachii tendon Cadaver Brachial artery Tendinopathy Percutaneous electrolysis Brachial Artery Electrolysis arteria braquial cadáver tendinopatía electrolisis |
| status_str | publishedVersion |
| title | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| title_full | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| title_fullStr | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| title_full_unstemmed | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| title_short | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| title_sort | Cadaveric and ultrasound validation of percutaneous electrolysis approach at the distal biceps tendon: a potential treatment for biceps tendinopathy |
| topic | Distal biceps brachii tendon Cadaver Brachial artery Tendinopathy Percutaneous electrolysis Brachial Artery Electrolysis arteria braquial cadáver tendinopatía electrolisis |
| topic_facet | Distal biceps brachii tendon Cadaver Brachial artery Tendinopathy Percutaneous electrolysis Brachial Artery Electrolysis arteria braquial cadáver tendinopatía electrolisis |
| url | http://hdl.handle.net/10366/169337 |