Percutaneous needle tenotomies: indications, procedures, efficacy and safety. A systematic review.

Acquired deforming hypertonia Contractures Deformities Minimally invasive procedure Percutaneous needle tenotomy Tendon Tenotomy

Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
01 Jun 2024
Historique:
received: 18 09 2023
revised: 16 02 2024
accepted: 20 02 2024
medline: 3 6 2024
pubmed: 3 6 2024
entrez: 2 6 2024
Statut: aheadofprint

Résumé

Percutaneous needle tenotomies constitute a promising approach that enables direct access to tendons through minimally invasive interventions. They can be performed rapidly without need for large incisions or general anaesthesia. However, the reported procedures are heterogeneous and currently conducted without guidelines. We aimed to determine the indications for percutaneous needle tenotomies described in the current literature. Our secondary aim was to identify the different procedures reported, as well as their efficacy and their safety. A systematic review following PRISMA guidelines was conducted to identify original articles that mentioned percutaneous needle tenotomy in humans and reported its application, description, effectiveness or adverse events. Non-percutaneous tendinous surgical procedures and ineligible designs were excluded. The Downs and Black checklist was used to assess the risk of bias. A total of 540 studies were identified from the MEDLINE, Embase, Cochrane Library, and PEDro databases. Fourteen clinical studies met the inclusion criteria and were found to have an acceptable quality (674 individuals, 1664 tenotomies). Our results indicated a wide variety of indications for percutaneous needle tenotomies in children and in adults. We highlighted 24 tendons as eligible targets in the upper and lower limbs. Tenotomies were performed with either 16- or 18-Ga needles, lasted from 1 to 30 min, and were performed using various procedures. Their efficacy was mainly assessed through clinical outcomes highlighting tendon discontinuity on palpation after the procedure. Passive range-of-motion gains after tenotomy were reported for both upper and lower limbs with an estimated 5 % complication rate. This is the first review to systematically synthesize all the available evidence on the indications, procedures, efficacy and safety of percutaneous tenotomies exclusively performed with needles. Current evidence suggests that procedures are safe and effective for treating various deformities. CRD42022350571.

Sections du résumé

BACKGROUND BACKGROUND
Percutaneous needle tenotomies constitute a promising approach that enables direct access to tendons through minimally invasive interventions. They can be performed rapidly without need for large incisions or general anaesthesia. However, the reported procedures are heterogeneous and currently conducted without guidelines.
OBJECTIVES OBJECTIVE
We aimed to determine the indications for percutaneous needle tenotomies described in the current literature. Our secondary aim was to identify the different procedures reported, as well as their efficacy and their safety.
METHODS METHODS
A systematic review following PRISMA guidelines was conducted to identify original articles that mentioned percutaneous needle tenotomy in humans and reported its application, description, effectiveness or adverse events. Non-percutaneous tendinous surgical procedures and ineligible designs were excluded. The Downs and Black checklist was used to assess the risk of bias.
RESULTS RESULTS
A total of 540 studies were identified from the MEDLINE, Embase, Cochrane Library, and PEDro databases. Fourteen clinical studies met the inclusion criteria and were found to have an acceptable quality (674 individuals, 1664 tenotomies). Our results indicated a wide variety of indications for percutaneous needle tenotomies in children and in adults. We highlighted 24 tendons as eligible targets in the upper and lower limbs. Tenotomies were performed with either 16- or 18-Ga needles, lasted from 1 to 30 min, and were performed using various procedures. Their efficacy was mainly assessed through clinical outcomes highlighting tendon discontinuity on palpation after the procedure. Passive range-of-motion gains after tenotomy were reported for both upper and lower limbs with an estimated 5 % complication rate.
CONCLUSION CONCLUSIONS
This is the first review to systematically synthesize all the available evidence on the indications, procedures, efficacy and safety of percutaneous tenotomies exclusively performed with needles. Current evidence suggests that procedures are safe and effective for treating various deformities.
PROSPERO REGISTRATION UNASSIGNED
CRD42022350571.

Identifiants

DOI: 10.1016/j.rehab.2024.101839 PMID: 38824898
pubmed: 38824898
pii: S1877-0657(24)00023-X
doi: 10.1016/j.rehab.2024.101839
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101839

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Hugo Bessaguet (H)

Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Inter-university Laboratory of Human Movement Biology, "Physical Ability and Fatigue in health and disease" team (F-42023), Saint-Etienne "Jean Monnet" & Lyon 1 & "Savoie Mont-Blanc" universities, Saint- Etienne, France. Electronic address: hugo.bessaguet@univ-st-etienne.fr.

Paul Calmels (P)

Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Inter-university Laboratory of Human Movement Biology, "Physical Ability and Fatigue in health and disease" team (F-42023), Saint-Etienne "Jean Monnet" & Lyon 1 & "Savoie Mont-Blanc" universities, Saint- Etienne, France.

Alexis Schnitzler (A)

Physical and Rehabilitation Medicine Department, Fernand-Widal Lariboisière University Hospital, 200, Faubourg Saint Denis street, 75010 Paris, France.

Flavia Coroian (F)

Physical and Rehabilitation Medicine Department, Lapeyronie University Hospital, 191, Doyen Gaston Giraud avenue, 34090 Montpellier, France.

Pascal Giraux (P)

Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Lyon Neuroscience Research Center, Trajectoires team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 & Saint-Etienne Universities), France.

Florence Angioni (F)

Physical and Rehabilitation Medicine Department, Fernand-Widal Lariboisière University Hospital, 200, Faubourg Saint Denis street, 75010 Paris, France.

Ahmed Adham (A)

Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France.

Philippe Denormandie (P)

Orthopedic Surgery Department, Raymond-Poincaré University Hospital, 104, Raymond-Poincaré boulevard, 92380 Garches, France.

Romain David (R)

Physical and Rehabilitation Medicine Department, PRISMATICS Lab, University Hospital of Poitiers, 2, La Milétrie street, 86000 Poitiers, France.

Etienne Ojardias (E)

Physical and Rehabilitation Medicine Department, University Hospital of Saint-Etienne, 25, boulevard Pasteur, 42100 Saint- Etienne, France; Lyon Neuroscience Research Center, Trajectoires team (Inserm UMR-S 1028, CNRS UMR 5292, Lyon 1 & Saint-Etienne Universities), France.

Classifications MeSH