scholarly journals Study comparing the efficacy of platelet rich plasma versus steroid versus placebo in lateral epicondylitis

2017 ◽  
Vol 3 (2) ◽  
pp. 207
Author(s):  
Ganesh Kumar Reddy Mundla ◽  
Praveen Kumar Venkataramana ◽  
Manoj Kumar Reddy Koduru ◽  
Biju Ravindran
Keyword(s):  
Normal Saline ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Randomized Study ◽  
Lateral Epicondylitis ◽  
College Hospital ◽  
Elbow Pain ◽  
Therapy Assessment ◽  
Medical College ◽  
Pre Treatment

<p><strong>Background: </strong>Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection &amp; other modes of conservative management. Hence, this study was done to evaluate PRP efficacy in our clinical setup and in the people of age group most commonly being affected.<strong></strong></p><p><strong>Methods: </strong>This randomized study was conducted at Narayana Medical College Hospital, Nellore, for a period of two years from December 2014 to June 2016 on 150 consenting patients diagnosed as suffering from lateral epicondylitis. Using lottery method for randomization the patients were divided into three groups, based on which the treatment was received. Group –N with 50 patients received 3 ml of normal saline as placebo. Group –P with 50 patients received 3 ml of extracted PRP injection. Group –S with 50 patients received depot preparation of 40 mg of methyl prednisiolone injected into the affected area. The data collected and recorded in the appropriate proforma. Post therapy assessment was done using with Oxford elbow score.</p><p><strong>Results:  </strong>The overall mean ages of the patients in the three groups (Group P, Group S and Group N) are 38.62±7.53, 37.82±7.79 and 36.3±6.93 respectively. Female preponderance was observed in all the groups. Most common presenting complaint was elbow pain seen in 100% of cases. Most common side involved was the dominant side, right side involvement was seen in 136 cases and left side in 14 cases. The Oxford elbow score pre-treatment in all the groups was not statistically significant and the Oxford elbow score at the end of 12 weeks and 24 weeks treatment showed that PRP and steroid was better than normal saline in control of pain.<strong></strong></p><p><strong>Conclusion: </strong>Lateral epicondylitis or tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments.</p>

scholarly journals STUDY COMPARING THE EFFICACY OF PLATELET RICH PLASMA VERSUS TRIAMCINOLONE IN TREATING TENNIS ELBOW

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Pratush Kumar Goyal ◽  
Anil Kumar Pandey ◽  
Akhil Bansal ◽  
Mohammad Zuber
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Randomized Study ◽  
Lateral Epicondylitis ◽  
Age Group ◽  
Elbow Pain ◽  
Therapy Assessment ◽  
Pre Treatment ◽  
Gandhi Medical College ◽  
Group 1

Background: Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection & other modes of conservative management. Hence, this study was done to evaluate PRP efficacy in our clinical setup and in the people of age group most commonly being affected. Methods: This randomized study was conducted at Gandhi Medical College & Hamidia Hospital, Bhopal, for a period of two years from Aug 2015 to Sep 2017 on 60 consenting patients diagnosed as suffering from lateral epicondylitis. Using lottery method for randomization the patients were divided into two groups, based on which the treatment was received. Group –1 with 30 patients received 2 ml of PRP. Group –2 with 30 patients received 2 ml of Triamcinolone injection. The data collected and recorded in the appropriate proforma. Post therapy assessment was done using with Oxford elbow score. Results:  Average age at presentation was 31.11 years, Range of age was from 20 to 40 years. Maximum incidence was in the age group of 35 to 40 years. Female preponderance was observed in Group 1. Most common presenting complaint was elbow pain seen in 100% of cases. Most common side involved was the dominant side right side involvement was seen in 41 cases and left side in 19 cases. The Oxford elbow score pre-treatment in all the groups was not statistically significant and the Oxford elbow score at the end of 6 weeks,12 weeks and 24 weeks treatment showed that PRP is better than  steroid  in control of pain. Conclusion: Lateral epicondylitis/Tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments. Keywords: Tennis elbow, Platelet rich plasma, Steroid, Triamcinolone, Lateral epicondylitis

scholarly journals A study on management of tennis elbow by local platelet rich plasma injection

2019 ◽  
Vol 5 (4) ◽  
pp. 703
Author(s):  
Wazir Fahad Jan ◽  
Alamgir Jahan ◽  
Mohd Yahya Dar ◽  
Umer Mushtaq Khan
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Local Injection ◽  
Dash Score ◽  
Full Extension ◽  
College Hospital ◽  
Medical College ◽  
Plasma Injection ◽  
Pre Treatment

<p class="abstract"><strong>Background:</strong> Lateral epicondylitis (tennis elbow), a familiar term used to describe myriad symptoms around the lateral aspect of the elbow can occur during activities that require repetitive supination and pronation of the forearm with the elbow in near full extension. This condition can cause severe discomfort to the patient resulting in debilitation and impairment of routine activities. The purpose of this study was to evaluate the effectiveness of local autologous platelet rich plasma injection in the treatment of tennis elbow.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study conducted on 50 patients of either sex with an average age of 45.92 years, presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, NUH, Haryana between November 2016 and February 2018, with a diagnosis of lateral epicondylitis. All the patients were treated with local platelet rich plasma injection and the results were analysed through the assessment of visual analog score (VAS) and disability of arm shoulder and hand (DASH) score. The patients were followed up for a period of 6 months after the local injection of platelet rich plasma.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients had significant relief with this method. The VAS and DASH score improved from the pre-treatment values of 8.7 and 74.6 to 2.6 and 29.8 respectively, which was found to be statistically significant (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Thus results of our study demonstrate that the local injection of platelet rich plasma is a safe and effective method of treatment of lateral epicondylitis.</p>

scholarly journals To evaluate the efficacy of platlet rich plasma injection in chronic lateral epicondylitis (tennis elbow)

2017 ◽  
Vol 3 (3) ◽  
pp. 375
Author(s):  
Rahul Kadam ◽  
Sachin Pandey ◽  
Abhay Chhallani ◽  
Santosh Pandhare ◽  
Abhishek Gupta ◽  
...  
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Cellular Level ◽  
Visual Analog Score ◽  
Secretory Proteins ◽  
Medical College ◽  
Vas Score ◽  
Number Of Patients ◽  
The Mean

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Platelet-rich plasma helps in repair because of its growth factor. Platelet-rich plasma has been used in humans for its healing properties. Increased concentration of growth factors and secretory proteins at may increase the process of healing on a cellular level. The PRP increases the incorporation of cells, proliferation, and differentiation in tissue regeneration of the cell involved.  This study was done to check the effectiveness of PRP injections in patients with chronic lateral epicondylitis or tennis elbow.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was done on the patients visiting the orthopaedic OPD at MGM medical college and hospital, kamothe, Navi Mumbai. Total number of patients for this study was 40 out of which 32 were male and 8 were females. The mean age of the patients was 48.1years (range 17-82 years).Study period was 3 months. Stastical tool used is visual analog score</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Successful treatment was taken as more than 20% reduction i.e.(24 out of 40 patients)  in visual analog score after 3 month. The mean VAS score was decreased from 6.98 to 4.91 after 3 months in males. While in females, mean VAS score was decreased from 6.66 to 5.22 after 3 months of PRP injection in lateral epicondylitis. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Treatment of patients with PRP with chronic lateral epicondylitis or tennis elbow with PRP reduces pain and increases function of the affected elbow joint.</span></p>

scholarly journals Evaluation of the Efficacy of Platelet Rich Plasma Injection in Chronic Lateral Epicondylitis

2020 ◽  
pp. 1-5
Author(s):  
K. Vivek
Keyword(s):  
Growth Factors ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Cellular Level ◽  
Visual Analog Score ◽  
Secretory Proteins ◽  
Medical College ◽  
Plasma Injection ◽  
The Mean

Background: Platelet-rich plasma helps in repair because of its growth factor. Platelet-rich plasma has been used in humans for its healing properties. Increased concentration of growth factors and secretory proteins may increase the process of healing on a cellular level. Aim: This study was done to check the effectiveness of PRP injections in patients with chronic lateral epicondylitis. Methodology: This was accomplished in patients visiting the orthopaedic OPD at the Sree Balaji Medical College and Hospital, Chennai, Tamilnadu. There were 40 physicians in this study, among whom 37 were homosexual and 87 were female. The mean age of the patients was 48.1 years (17-82 years). The study period was 3 months. The analytical method used is a visual analog score. Results: Effective therapy was performed with a decline of more than 20% (24 out of 40 patients) in visual analog score after a dual-month period. After 3 months in boys, the mean VAS score dropped from 6.88 to 9.41. Conclusion: Medication of PRP patients with chronic epicondylitis or PRP tennis elbow reduces pain and increases the flexibility of the affected knee joint.

scholarly journals Effects of intralesional platelet-rich plasma in the patients with lateral epicondylitis of elbow

2019 ◽  
Vol 12 (3) ◽  
pp. 138-141
Author(s):  
Mohammad Tariqul Islam ◽  
M. A. Shakoor ◽  
Afsana Mahjabin ◽  
Md. Ali Emran
Keyword(s):  
Visual Analogue Scale ◽  
Daily Living ◽  
Analogue Scale ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Activity Of Daily Living ◽  
Evaluation Tool ◽  
Plasma Injection ◽  
The Difference

Lateral epicondylitis (tennis elbow) is a major cause of musculoskeletal pain involving common extensor origin of the forearm. This study was done to determine the effects of platelet-rich plasma on 15 patients with lateral epicondylitis. Selected patients were given intralesional platelet-rich plasma injection, activity of daily living instructions and paracetamol. Patients were assessed every 14 days interval by visual analogue scale, and the patient rated tennis elbow evaluation. Treatment response according to visual analogue scale and patient rated tennis elbow evaluation tool, the difference of improvement was found in respect to time, from pretreatment W1 (just before 1st Intervention) score to W11 score in every alternate week (p<0.005). This indicates that intralesional platelet-rich plasma is effective in the patients with lateral epicondylitis of elbow.

scholarly journals Surgical Outcome of Chronic Subdural Haematoma: An Analysis of 300 Cases

2016 ◽  
Vol 24 (2) ◽  
pp. 126-131
Author(s):  
Sukriti Das ◽  
Asit Chandra Sarkar ◽  
Md Rafiqul Islam ◽  
Md Manirul Islam
Keyword(s):  
Normal Saline ◽  
Surgical Outcome ◽  
Subdural Haematoma ◽  
Subdural Space ◽  
Acute Subdural Haematoma ◽  
Related Factors ◽  
College Hospital ◽  
Complete Replacement ◽  
Poor General Health ◽  
Medical College

Chronic Subdural Heamatoma (CSDH) is defined as collection of blood in the brain’s surface, subdural space between dura and arachnoid. It is one of the most common clinical entities in daily neurosurgical practice among the elders, several weeks after the head injury. CSDH doesn’t always produce symptoms but when it does, it generally requires surgical treatment. The diagnosis and treatment are well established, but the cause of recurrence, complications and related factors are not completely understood. This study evaluated the clinical features, radiological findings and surgical results in a large series of patients treated at the Neurosurgery department of Dhaka Medical College Hospital. 300 consecutive patients (250 men and 50 women) age ranging from 30-85 years, GCS 5-15, volume of blood >25cc, symptomatic with CSDH were treated by one or two burr hole craniostomies. Haematoma cavity was irrigated with normal saline and closed system subdural drainage was continued for 1-2 days from January 2012 to December 2015. The clinical outcome was measure on 1st, 3rd, 5th and 7th POD using GCS scoring and GOS after 4 and 8 weeks of operations. Most patients 94%(282) had good recovery (GOS 5,4,3), 4%(12) showed no changes (GOS 2) and 2%(6) worsened (GOS 1). Recurrence of haematoma was recognized in 5%(15) patients 1-8 weeks after the first operation. 4%(12) patients suffered post operative complications of which 1.33%(4)patients were acute subdural haematoma caused by incomplete haemostasis of the scalp wound, 1.33%(4)patients were tension pneumocephalus and remaining due to hypertension, use of anticoagulants, poor general health and medical problems. Careful haemostasis and complete replacement of subdural haematoma with normal saline to prevent influx of air into the subdural space will further improve the surgical outcome for patients with CSDH.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 126-131

scholarly journals Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Leyla Sedighipour ◽  
Seyed Mansoor Rayegani ◽  
Mohammad Hasan Bahrami ◽  
Masume Bayat ◽  
...  
Keyword(s):  
Whole Blood ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Pressure Pain Threshold ◽  
Lateral Epicondylitis ◽  
Autologous Whole Blood ◽  
Significant Difference ◽  
Group 2 ◽  
And Function

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

scholarly journals Electrocardiographic abnormalities in severe anaemia and its reversibility after correction of anaemia

2020 ◽  
Vol 7 (10) ◽  
pp. 1566
Author(s):  
S. M. Biradar ◽  
Renuka Holiyachi ◽  
Mohd Shannawaz ◽  
V. Ravi Teja
Keyword(s):  
Clinical Manifestations ◽  
Severe Anaemia ◽  
Ecg Changes ◽  
College Hospital ◽  
Medical College ◽  
Wave Inversion ◽  
Pre Treatment ◽  
Organic Heart Disease ◽  
Hb Concentration ◽  
Ecg Abnormalities

Background: Anaemia is one of the commonest clinical problems in our country. It affects various organs including the heart. Clinical manifestations of anaemia referable to cardiovascular system may closely simulate symptoms and signs of organic heart disease. It includes some electrocardiogram (ECG) changes also. ECG changes in anaemia show correlation to haemoglobin (Hb) concentration and the changes are reversible after correction of anaemia. In this study, the main objective was to study electrocardiographic changes in patients with severe anaemia and ECG reversibility after treatment of anaemia.Methods: 50 patients admitted in medicine wards of Shri B. M. Patil Medical College, Hospital and Research Center, Vijayapura for severe anaemia (Hb concentration less than or equal to 7 gm %) were studied for ECG changes. All patients were reassessed for reversibility of changes after treatment.Results: Out of 50 patients with severe anaemia, 20 patients were having Hb % of 3 to 5 gm %. Of which 16 patients were having ECG changes (10 were females and 6 were males). All ECG changes were reverted to normal after correction of anaemia, except one patient (showed pre-treatment T wave inversion and post-treatment flat T waves).Conclusions: ECG abnormalities in patients with severe anaemia are more common in females. ECG abnormalities in patients with severe anaemia (Hb 5 gm %) can get reverted to normal after correction of anaemia.

Effect of Normal Saline Injections on Lateral Epicondylitis Symptoms: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2020 ◽  
Vol 48 (12) ◽  
pp. 3094-3102 ◽  
Author(s):  
Carlos Alberto Acosta-Olivo ◽  
Juan Manuel Millán-Alanís ◽  
Luis Ernesto Simental-Mendía ◽  
Neri Álvarez-Villalobos ◽  
Félix Vilchez-Cavazos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Visual Analog Scale ◽  
Normal Saline ◽  
Tennis Elbow ◽  
Meta Analysis ◽  
Lateral Epicondylitis ◽  
Mean Difference ◽  
Analog Scale ◽  
Meaningful Improvement

Background: Lateral epicondylitis, or tennis elbow, is a painful degenerative disorder that commonly occurs in adults between 40 and 60 years of age. Normal saline (NS) injections have been used as placebo through a large number of randomized controlled trials (RCTs) focused on the treatment of lateral epicondylitis. Purpose: This meta-analysis of RCTs aimed to assess the therapeutic effect of NS injections on lateral epicondylitis symptoms and compare results with established minimal clinically important difference criteria. Study Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, Web of Science, and Scopus databases were searched for clinical trials reporting pain and joint function with the visual analog scale, Patient-Rated Tennis Elbow Evaluation, and Disabilities of the Arm, Shoulder and Hand in patients with lateral epicondylitis. The meta-analysis was conducted with a random effects model and generic inverse variance method. Heterogeneity was tested with the I2 statistic index. Results: A total of 15 RCTs included in this meta-analysis revealed a significant improvement in pain (mean difference, 3.61 cm [95% CI, 2.29-4.92 cm]; P < .00001; I2 = 88%; visual analog scale) and function (mean difference, 25.65 [95% CI, 13.30-37.99]; P < .0001; I2 = 82%; Patient-Rated Tennis Elbow Evaluation / Disabilities of the Arm, Shoulder and Hand) after NS injection (≥6 months). Conclusion: NS injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis. New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT. Registration: CRD42019127547 (PROSPERO).

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