Lateral Elbow Tendinopathy: Development of a Pathophysiology-Based Treatment Algorithm

Gev Bhabra, Allan Wang, Jay R. Ebert, Peter Edwards, Monica Zheng, Ming H. Zheng

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Lateral elbow tendinopathy, commonly known as tennis elbow, is a condition that can cause significant functional impairment in working-age patients. The term tendinopathy is used to describe chronic overuse tendon disorders encompassing a group of pathologies, a spectrum of disease. This review details the pathophysiology of tendinopathy and tendon healing as an introduction for a system grading the severity of tendinopathy, with each of the 4 grades displaying distinct histopathological features. Currently, there are a large number of nonoperative treatments available for lateral elbow tendinopathy, with little guidance as to when and how to use them. In fact, an appraisal of the clinical trials, systematic reviews, and meta-analyses studying these treatment modalities reveals that no single treatment reliably achieves outstanding results. This may be due in part to the majority of clinical studies to date including all patients with chronic tendinopathy rather than attempting to categorize patients according to the severity of disease. We relate the pathophysiology of the different grades of tendinopathy to the basic science principles that underpin the mechanisms of action of the nonoperative treatments available to propose a treatment algorithm guiding the management of lateral elbow tendinopathy depending on severity. We believe that this system will be useful both in clinical practice and for the future investigation of the efficacy of treatments.

    Original languageEnglish
    Pages (from-to)1-10
    Number of pages10
    JournalOrthopaedic Journal of Sports Medicine
    Volume4
    Issue number11
    DOIs
    Publication statusPublished - 1 Nov 2016

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    Tendinopathy
    Tendons
    Tennis Elbow
    Therapeutics
    Meta-Analysis
    Elbow Tendinopathy
    Clinical Trials
    Pathology

    Cite this

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    abstract = "Lateral elbow tendinopathy, commonly known as tennis elbow, is a condition that can cause significant functional impairment in working-age patients. The term tendinopathy is used to describe chronic overuse tendon disorders encompassing a group of pathologies, a spectrum of disease. This review details the pathophysiology of tendinopathy and tendon healing as an introduction for a system grading the severity of tendinopathy, with each of the 4 grades displaying distinct histopathological features. Currently, there are a large number of nonoperative treatments available for lateral elbow tendinopathy, with little guidance as to when and how to use them. In fact, an appraisal of the clinical trials, systematic reviews, and meta-analyses studying these treatment modalities reveals that no single treatment reliably achieves outstanding results. This may be due in part to the majority of clinical studies to date including all patients with chronic tendinopathy rather than attempting to categorize patients according to the severity of disease. We relate the pathophysiology of the different grades of tendinopathy to the basic science principles that underpin the mechanisms of action of the nonoperative treatments available to propose a treatment algorithm guiding the management of lateral elbow tendinopathy depending on severity. We believe that this system will be useful both in clinical practice and for the future investigation of the efficacy of treatments.",
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    Lateral Elbow Tendinopathy : Development of a Pathophysiology-Based Treatment Algorithm. / Bhabra, Gev; Wang, Allan; Ebert, Jay R.; Edwards, Peter; Zheng, Monica; Zheng, Ming H.

    In: Orthopaedic Journal of Sports Medicine, Vol. 4, No. 11, 01.11.2016, p. 1-10.

    Research output: Contribution to journalArticle

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