{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:22:06Z","timestamp":1788337326452,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Lateral elbow tendinopathy (LET) is a common upper-limb musculoskeletal disorder causing pain during gripping activities, reduced work capacity, and functional limitation. LET is currently considered a predominantly degenerative condition characterized by collagen disorganization, extracellular matrix changes, neovascularization, and impaired tendon healing. Objective: To evaluate short-term clinical and functional outcomes of a multimodal protocol including focused extracorporeal shock wave therapy (f-ESWT), ultrasound-guided intralesional injection of low-molecular-weight peptides (LWPs) derived from hydrolyzed bovine collagen and therapeutic exercise in patients with chronic LET unresponsive to standardized conservative therapy. Methods: This retrospective observational study included 11 screened patients; 10 completed follow-up. Eligibility required age \u2265 18 years, symptoms \u2265 3 months, positive provocation tests, ultrasound-confirmed common extensor tendon pathology, and incomplete response to prior treatment. All patients received f-ESWT before ultrasound-guided LWPs injection and performed progressive loading exercises. Outcomes included Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength, and clinical provocation tests at baseline (T0; Day 0) and at T1 (Day 51, 30 days after injection). Results: PRTEE pain improved by 31.2 points (95% CI 22.2\u201340.2; Cohen\u2019s d_z = 2.48) and PRTEE function by 32.6 points (95% CI 26.7\u201338.5; d_z = 3.95). Mean maximal strength and maximal strength improved by 4.61 kg (95% CI 2.89\u20136.32) and 4.02 kg (95% CI 2.36\u20135.68), respectively. Clinical test severity decreased by an estimated 2.5 points (95% CI 2.0\u20133.0). No adverse events were reported. Conclusions: Patients showed clinically meaningful short-term improvements in pain, function, and strength following the sequential multimodal management strategy. However, the retrospective design, small sample, lack of control group, and short follow-up preclude causal attribution and require confirmation in prospective controlled studies.<\/jats:p>","DOI":"10.3390\/life16091465","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"1465","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Guided Collagen Peptides Injections Combined with Focused Extracorporeal Shockwave Therapy and Therapeutic Exercise in Chronic Partial Common Extensor Tendon Tears at Elbow Lateral Epicondyle: A Retrospective Case Series"],"prefix":"10.3390","volume":"16","author":[{"given":"Nicol\u00f2","family":"Vitale","sequence":"first","affiliation":[{"name":"Centro Medicina Riabilitativa \u201cCMR\u201d, 95031 Adrano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6012-5619","authenticated-orcid":false,"given":"Luca","family":"Latini","sequence":"additional","affiliation":[{"name":"Centro Medico e Fisioterapia \u201cSalute e Benessere\u201d, 60019 Senigallia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Marco","family":"Di Ges\u00f9","sequence":"additional","affiliation":[{"name":"MyaRehab, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Ilias","family":"Vurliotis","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Universit\u00e0 Politecnica delle Marche, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-606X","authenticated-orcid":false,"given":"Marianna","family":"Capecci","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, Universit\u00e0 Politecnica delle Marche, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Valerio Sebastiano","family":"Amico","sequence":"additional","affiliation":[{"name":"G2 Medica, 95129 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Florentin Ananu","family":"Vreju","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Emilio","family":"Filippucci","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60035 Jesi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","first-page":"1117","article-title":"Tennis elbow","volume":"2011","author":"Bisset","year":"2011","journal-title":"BMJ Clin. 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