Tennis Elbow and Golfer's Elbow Treated with TAME — Case Report

 

Ms. K, 52 years old, had suffered from left elbow pain for over 10 years. After seeking medical attention, she was diagnosed with "lateral epicondylitis," commonly known as "tennis elbow." She had long used painkillers and patches, and received rehabilitation, local injections, regenerative medicine treatments, and even underwent arthroscopy, but the pain had not significantly improved, and her pain index reached 7 to 8 out of 10.

She consulted with National Cheng Kung University Hospital Orthopedics and was subsequently referred to the Interventional Medicine Center for further discussion.

After discussion, Bow Wang, M.D. ultimately chose to perform "transarterial embolization treatment" for Ms. K. Guided by X-ray fluoroscopy, under local anesthesia, a puncture was performed via the femoral artery in the groin (or radial artery).

A microcatheter was inserted into the painful area. Under arterial angiography, a contrast agent was injected to identify newly formed capillary-like vessels. Embolizing medication was then injected through the microcatheter to remove these abnormal capillary-like vessels.

After the embolization was completed, two weeks later, the pain index finally dropped to 1 point.

However, Bow Wang, M.D. cautions that transarterial embolization (TAI) for tennis elbow/golfer's elbow has limitations. The primary indication is a pain index exceeding 5 points, and patients who have not shown significant improvement after more than three months of various treatments.

This treatment is not suitable in the following situations:

1. Severe tendon or ligament damage or rupture

2. Pain accompanied by other nerve compression symptoms, such as numbness

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. The patient is unable to lie flat for two hours

6. Pregnancy

Side effects of the treatment may include local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site may occur, which will improve and disappear within several days to a month.

It is recommended that patients undergo a detailed evaluation by a physician to confirm the true source of pain, and have a thorough discussion with their doctor and family to understand the treatment process and related precautions before receiving treatment.

Furthermore, Bow Wang, M.D. reminds patients that after treatment, it is still important to pay attention to proper rest and protection, and to do appropriate exercise and maintenance every day. This will allow the tissues room to repair and adapt to the load, and also make it less likely for the condition to worsen again.