Abstract：
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.
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: 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: 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.
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.
UNASSIGNED: CRD42022350571.
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: 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: 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.
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.
UNASSIGNED: CRD42022350571.
摘要：
背景：经皮穿刺肌腱切开术是一种有前途的方法，可以通过微创干预直接进入肌腱。它们可以快速进行，无需大切口或全身麻醉。然而,报告的程序是不同的,目前在没有指南的情况下进行.
目的：我们的目的是确定目前文献中描述的经皮穿刺肌腱切开术的适应症。我们的次要目标是确定报告的不同程序，以及它们的功效和安全性。
方法：遵循PRISMA指南进行了系统评价，以确定提及人类经皮针张力切开术的原始文章，并报告了其应用，描述,有效性或不良事件。不包括非经皮肌腱外科手术和不合格的设计。Downs和Black检查表用于评估偏见的风险。
结果：共有540项研究来自MEDLINE，Embase,科克伦图书馆,和PEDro数据库。14项临床研究符合纳入标准，并被发现具有可接受的质量(674名个体，1664张力切开术）。我们的结果表明，在儿童和成人中，经皮穿刺性肌腱切开术有多种适应症。我们强调了24条肌腱是上肢和下肢的合格目标。使用16-或18-Ga针进行肌腱切开术，持续1到30分钟，并使用各种程序进行。其疗效主要通过术后触诊时突出显示肌腱不连续性的临床结果进行评估。据报道，上肢和下肢肌腱切开术后的被动活动范围增加，估计并发症发生率为5％。
结论：这是第一次系统地综合所有关于适应症的现有证据的综述，程序,仅用针进行经皮肌腱切开术的有效性和安全性。目前的证据表明，手术对于治疗各种畸形是安全有效的。
■CRD42022350571。
目的：我们的目的是确定目前文献中描述的经皮穿刺肌腱切开术的适应症。我们的次要目标是确定报告的不同程序，以及它们的功效和安全性。
方法：遵循PRISMA指南进行了系统评价，以确定提及人类经皮针张力切开术的原始文章，并报告了其应用，描述,有效性或不良事件。不包括非经皮肌腱外科手术和不合格的设计。Downs和Black检查表用于评估偏见的风险。
结果：共有540项研究来自MEDLINE，Embase,科克伦图书馆,和PEDro数据库。14项临床研究符合纳入标准，并被发现具有可接受的质量(674名个体，1664张力切开术）。我们的结果表明，在儿童和成人中，经皮穿刺性肌腱切开术有多种适应症。我们强调了24条肌腱是上肢和下肢的合格目标。使用16-或18-Ga针进行肌腱切开术，持续1到30分钟，并使用各种程序进行。其疗效主要通过术后触诊时突出显示肌腱不连续性的临床结果进行评估。据报道，上肢和下肢肌腱切开术后的被动活动范围增加，估计并发症发生率为5％。
结论：这是第一次系统地综合所有关于适应症的现有证据的综述，程序,仅用针进行经皮肌腱切开术的有效性和安全性。目前的证据表明，手术对于治疗各种畸形是安全有效的。
■CRD42022350571。
