scholarly journals Management of lateral epicondylitis (tennis elbow) by local infiltration of platelet rich plasma an outcome study

2020 ◽  
Vol 6 (5) ◽  
pp. 963
Author(s):  
Pradeep Kumar Kumawat ◽  
Rajesh Goel ◽  
Urmila Kumhar ◽  
Rahul Parmar ◽  
Rajesh Sharma ◽  
...  
Keyword(s):  
Biological Therapy ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
P Value ◽  
Outcome Study ◽  
Post Intervention ◽  
Local Infiltration ◽  
And Function

<p class="abstract"><strong>Background:</strong> Platelet-rich plasma (PRP) has been recently the emerging biological therapy in which a large pool of signals released from platelets producing a biological microenvironment for local and migrating cells for tissue regeneration. A prospective randomized observational study was done to assess the efficacy of autologous PRP injection in lateral epicondylitis of elbow.</p><p class="abstract"><strong>Methods:</strong> A total 100 patients of lateral epicondylitis were selected and treated from December 2015 to November 2017. VAS (visual analogue scale) and PRTEE (patient rated tennis elbow evaluation) scoring were used for clinical and functional assessment at pre-injection, 2<sup>nd</sup> week, 4<sup>th </sup>week, 3<sup>rd</sup> month and 6<sup>th</sup> month.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of 6 months follow-up 61% patients were completely relieved of pain. 34% patients had mild pain that was significantly decreased (p value &lt;0.0001) from mean VAS (75) and mean PRTEE (78.62) to mean VAS (6.05) and mean PRTEE (5.63). 5 patients were lost their 6 months follow-up. There was a significant increase in post intervention pain for few days in 70% patients. Recurrence rate of 0% was noted at the end of 6 months follow-up.</p><p class="abstract"><strong>Conclusions:</strong> An injection of PRP improves pain and function in patients suffering from lateral epicondylitis.</p>

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 A better functional outcome with platelet rich plasma compared with local steroid injection in tennis elbow

2021 ◽  
Vol 7 (1) ◽  
pp. 24-28
Author(s):  
Shilp Verma ◽  
Anwar A ◽  
Alok Chandra Agarwal ◽  
Ranjeet Choudhary ◽  
Ankit Kumar Garg
Keyword(s):  
Steroid Injection ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Symptomatic Relief ◽  
Lateral Epicondylitis ◽  
Treatment Modalities ◽  
Functional Activities ◽  
Local Steroid Injection

Lateral epicondylitis commonly referred to as 'tennis elbow,' is mainly observed in the 3rd and 4th decade of life in around 2% -3% of the population. Treatment modalities for lateral epicondylitis include analgesics, immobilization, tennis elbow brace, local steroid infiltration, and ultrasound therapy. Recent studies have explored the effectiveness of platelet-rich plasma (PRP) injections in lateral epicondylitis. We used the block randomization technique. Two groups were prepared with 30 patients in each group. One group of patients received PRP and the other received local steroid injection. Patients were evaluated at the time of procedure and immediately after the procedure, at six weeks, three months, and six months, using the visual analog score and Liverpool's elbow score. At the end of 6 months, follow-up patients in the PRP injection group show good clinical and functional compare to the steroid group of patients. PRP and local corticosteroid injection provide symptomatic relief in the treatment of lateral epicondylitis. PRP infiltration gives better results in pain relief and functional activities with statically significant values when compared with corticosteroid injections.

scholarly journals Comparison of efficacy of needling and a combination of needling and platelet rich plasma in relieving pain and improving function in patients of tennis elbow: a prospective, randomized, double blinded, placebo controlled clinical trial

2021 ◽  
Vol 7 (2) ◽  
pp. 258
Author(s):  
Vikram Sharma ◽  
Vivek Chandak
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Secondary Outcome ◽  
Controlled Clinical Trial ◽  
Group A ◽  
Group B ◽  
Double Blinded

<p><strong>Background: </strong>Lateral epicondylitis is a common musculoskeletal disorder for which an effective treatment strategy remains unknown. Aim of the study was to examine whether a single injection of platelet-rich plasma (PRP) with needling is more effective than needling with placebo in reducing pain in adults with lateral epicondylitis. Study design used was randomized controlled trial.    </p><p><strong>Methods: </strong>A total of 66 patients with chronic lateral epicondylitis were randomized (1:1) to receive either a blinded injection of PRP (group A) or saline (placebo) group B. The primary end point was a change in pain using the VAS and patient-rated tennis elbow evaluation (PRTEE) questionnaire. The secondary outcome being improvement in function (PRTEE scores).<strong></strong></p><p><strong>Results: </strong>The VAS score and PRTEE score improved significantly in both the groups at all 3 follow-up examinations. Group A had significantly better results than the group B.</p><p><strong>Conclusions: </strong>PRP injection are safe and effective management strategy for lateral epicondylitis</p>

Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic Lateral Epicondylitis

2016 ◽  
Vol 25 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Tristan Rodik ◽  
Brendon McDermott
Keyword(s):  
Whole Blood ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Lateral Epicondylitis ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
And Function ◽  
Corticosteroid Injections

Clinical Scenario:Lateral epicondylitis (LE) is a relatively common pathology capable of producing chronic debilitation in a variety of patients. A newer treatment for orthopedic conditions is platelet-rich plasma (PrP) local injection.Focused Clinical Question:Is PrP a more appropriate injection therapy for LE than other common injections such as corticosteroid or whole blood?Summary of Key Findings:Four studies were included: 1 randomized controlled trial (RCT), 2 double-blind RCTs, and 1 cohort study. Two studies involved comparisons of PrP injection to corticosteroid injection. One of the studies involved a 2-y follow-up while another involved a 1-y follow-up. Another study involved the comparison of PrP injection with whole-blood injection with a 6-mo follow-up. The final study included a PrP-injection group and control group. The 2 studies involving PrP vs corticosteroid injections with 2-y and 1-y follow-ups both favored PrP over corticosteroid injection in terms of pain reduction and function increases. The third study favored PrP injections over whole-blood injections at 6 mo regarding pain reduction. All studies demonstrated significant improvements with PrP over comparison injections or no injection.Clinical Bottom Line:PrP injections provide more favorable pain and function outcomes than whole blood and corticosteroid injections for 1–2 y after injection.Strength of Recommendation:Consistent findings from RCTs suggest level 1b evidence in support of PrP injection as a treatment for LE.

scholarly journals Platelet-Rich Plasma Injection With Percutaneous Needling for Recalcitrant Lateral Epicondylitis: Comparison of Tenotomy and Fenestration Techniques

2017 ◽  
Vol 5 (12) ◽  
pp. 232596711774207 ◽  
Author(s):  
Michael P. Gaspar ◽  
Michael A. Motto ◽  
Sarah Lewis ◽  
Sidney M. Jacoby ◽  
Randall W. Culp ◽  
...  
Keyword(s):  
Grip Strength ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Clinical Importance ◽  
Lateral Epicondylitis ◽  
Study Cohort ◽  
Level Of Evidence ◽  
Entire Study

Background: Recalcitrant lateral epicondylitis (LE) is a common debilitating condition, with numerous treatment options of varying success. An injection of platelet-rich plasma (PRP) has been shown to improve LE, although it is unclear whether the method of needling used in conjunction with a PRP injection is of clinical importance. Purpose: To determine whether percutaneous needle tenotomy is superior to percutaneous needle fenestration when each is combined with a PRP injection for the treatment of recalcitrant LE. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 93 patients with recalcitrant LE were treated with a PRP injection and percutaneous needle fenestration (n = 45) or percutaneous needle tenotomy (n = 48) over a 5-year study interval. Preoperative patient data, including visual analog scale for pain (VAS-P), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Patient-Rated Tennis Elbow Evaluation (PRTEE) scores and grip strength, were obtained from a chart review and compared with postoperative values obtained prospectively. Secondary outcomes included the incidence of complications, need for additional interventions, return to work, and patient satisfaction. Results: At a mean follow-up of 40 months, significant improvements in VAS-P (mean, –6.1; 95% CI, –6.8 to –5.5; P < .0001), QuickDASH (mean, –46; 95% CI, –52 to –40; P < .0001), and PRTEE (mean, –57; 95% CI, –64 to –50; P < .0001) scores and grip strength (mean, +6.1 kg; 95% CI, 4.9 to 7.3; P < .0001) were observed across the entire study cohort, with no significant differences noted between the fenestration and tenotomy groups. Nine of 45 patients (22%) underwent additional procedures to treat recurrent symptoms in the fenestration group compared with 5 of 48 patients (10%) in the tenotomy group ( P = .05). No complications occurred in any patients, and no patients expressed dissatisfaction with their treatment course. Conclusion: A PRP injection with concomitant percutaneous needling is an effective treatment for recalcitrant LE, with sustained improvements in pain, strength, and function demonstrated at a mean follow-up of longer than 3 years. Although the method of concomitant needling does not appear to have a significant effect on treatment outcomes, more aggressive needle tenotomy is less likely to require conversion to open tenotomy than needle fenestration in the short term to midterm.

scholarly journals Chronic Tennis Elbow Treated by Platelet-Rich Plasma Versus Steroid Injections: A Comparative Study

2020 ◽  
Vol 15 (2) ◽  
pp. 35-39
Author(s):  
Mohammed Sh. Al-Edanni
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
P Value ◽  
First Line ◽  
Analog Scale ◽  
Lateral Epicondyle ◽  
Pain Scores ◽  
Group A ◽  
Group B

Background: Painful elbow joint over the lateral epicondyle especially with resisted wrist extension are common signs of lateral epicondyle tendinopathy, also called tennis elbow. Objective: To evaluate the clinical outcome of local platelet rich plasma (PRP) injection in patients with chronic tennis elbow compared with a steroid (Depomedrol 40 mg) injection. Methods: A total of 88 patients with chronic tennis elbow were treated at Al-Kindy Teaching Hospital and private clinics. All patients had chronic pain for about 24 weeks or more and had failed first line treatment. The patients dividing into two groups, Group A injected with PRP (n = 44), and group B injected with depomedrol 40 mg (n = 44). A good clinical result was demarcated as 25% or more progress on the visual analog scale for pain. All patients followed for 6 months in both group for clinical successful result. Results: At three months (n = 44), in group A reported a perfection of 58.2% in their pain scores while 49.3% in the group B (N = 44). At 6 months follow up, the group A informed a perfection of 74.3% in their pain scores while 58.4 % in the group B. The local elbow tenderness recording at three months was 37.4% in the group A, while in the group B was 48.4%. At six months, 16.1% versus 30.2%   recounted major elbow tenderness (P = .009) in groups (A and B) respectively. The clinical improvement rates at three months revealed no changes between both groups while it showed more significant clinically changes in group A ( 87.1%) than in group B (70.1 %) with P value = 0.008 after six months follow up. Conclusion: No important changes were found at 3 months in both groups, but at 6months, clinical significant perfections in patients treated with PRP group (group A)

scholarly journals A Single Blind Randomised Clinical Study Of Outcome Of Local Injection Of Platelet Rich Plasma Vs Methyl Prednisolone Acetate In Management Of Lateral Epicondylitis

2020 ◽  
Vol 11 (3) ◽  
pp. 4949-4955
Author(s):  
Kumar Shubham ◽  
Kulkarni P N ◽  
Kshirsagar A Y
Keyword(s):  
Diabetes Mellitus ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Prednisolone Acetate ◽  
Methyl Prednisolone ◽  
Group A ◽  
The Mean ◽  
Group B

The most well-known abuse condition is identified with inordinate wrist expansion and generally alluded to as tennis elbow, however it is in reality increasingly regular in non-tennis players. METHODS- A prospective, comparative study was conducted with 50 patients after Ethical approval. Quantitative data is presented with Mean and Standard deviation. Examination among the investigation bunches is finished with the assistance of unpaired t test according to consequences of ordinariness test. Majority of the patients (80%) in Group A and (76%) in Group B were from the age group of 31-40 years. The mean age in Group A was 36.4±5.44 years and in Group B were 36.8±5.87 years. Majority of the patients in both groups were female. There was dominance of right side (68% and 72%) as compared to left side (32% and 28%) in both groups. The mean duration of symptom in Group A was 2.24±0.72 months as compared to 1.92±0.81 months in Group B. 20% and 12% patients in Group A had Diabetes Mellitus and Hypertension respectively whereas 16% and 24% patients in Group B had Diabetes Mellitus and Hypertension respectively. The mean baseline VAS score in Group A was 7.6±0.51 and Group B was 7.7±0.38 which decreased to 5.1±0.81. The mean baseline MGS score in Group A was 74.6±10.32 which increased to 91.6±4.08 in 2 weeks. And in Group B was 74.5±10.31 which increased to 99.8±2.646 in 2 weeks. The MGS score improved more in Group B after 2 weeks (p=0.005), 4 weeks (p=0.002) and 6 weeks (p=0.022). However, toward the finish of 3 months, a half year and a year, improvement in MGS Score was fundamentally better in Group A as compared to Group B.Along these lines, we presumed that PRP as an unrivaled treatment choice in instances of tennis elbow. In any case, keeping in see the constrained time of follow up in the current examination we prescribe longer follow up studies to additionally unite our discoveries and set up the long haul viability of PRP in instances of sidelong epicondylitis.

Efficacy of powerball versus mulligan mobilization with movement on pain and function in patients with lateral epicondylitis: a randomised control trial

2021 ◽  
Author(s):  
Shivani Uttamchandani ◽  
Pratik Phansopkar
Keyword(s):  
Grip Strength ◽  
Tennis Elbow ◽  
Strength Function ◽  
Intervention Group ◽  
Lateral Epicondylitis ◽  
Randomised Control Trial ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Post Intervention ◽  
And Function

Abstract Background: Lateral epicondylitis (LE), most commonly referred to as Lateral Elbow Tendinopathy (LET) or Tennis Elbow is one of the commonest repetitive stress syndromes seen in elbow joint. Tendinopathy, an injury to forearm extensor muscles. These muscles arise from the distal end of humerus from lateral epicondylar region. In many cases, involvement of extensor carpi radialis brevis muscle’s insertion is seen. This study focuses on the treatment of a person with LE which occurs in repeated upper extremity movements. There is no such research relevant to PowerBall device exercises on Lateral epicondylitis patients' pain and function. “PowerBall device” exercise is considered to be an effective resistance training, putting extrinsic and intrinsic pressure on wrist, elbow and shoulder muscles and has been shown to improve strength, function, ROM, tennis elbow pain and quality of life. Whereas MMWM has been proven to reduce the pain in patients with LE. Methods/Design: The participants (n=50) with lateral epicondylitis will be included in a single-blinded, randomised control trial. Participants will be categorised into either a control group or an intervention group after performing baseline assessments and randomization. The participants in the control group will be given Mulligan Mobilisation with Movement, and those in the intervention group will be given “PowerBall device” exercise and conventional physiotherapy. Basic exercises and ultrasound will be given to both groups with the given protocol. We will evaluate pain, function, grip strength and Range of motion, pre and post intervention period. Discussion: Efficacy of the intervention is evaluated by analysing the pain and function in patients with lateral epicondylitis using PRTEE scale, and grip strength using Hand-held Dynamometer. The results from the study will significantly provide affirmation on the application of “PowerBall device” exercise and Mulligan Mobilisation with Movement on the patients with lateral epicondylitis.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033363.

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis

2020 ◽  
Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Short Term ◽  
Shockwave Therapy ◽  
Other Substances ◽  
Injured Tendon ◽  
Satisfaction Rates

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

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.

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