scholarly journals Hyaluronic Acid injections for Chronic Tennis Elbow

2021 ◽  
Author(s):  
Gershon Zinger ◽  
Alexander Bregman ◽  
Ori Safran ◽  
Shaul Beyth ◽  
Amos Peyser
Keyword(s):  
Hyaluronic Acid ◽  
Tennis Elbow ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Visual Analogue Score ◽  
Saline Control ◽  
Clinically Important Difference ◽  
Male Patients ◽  
One Year ◽  
Non Surgical Treatment

Abstract Background For most patients, tennis elbow (TE) resolves within six months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatment for TE, but usually fail. In this study, we test the hypothesis that injections with hyaluronic acid (HA) are effective at treating chronic pain from TE. Methods Patients with a minimum of six months of pain from TE were randomized equally into one of two groups, injection with HA or saline control, and followed for one year. Outcome measures included Visual Analogue Score (VAS pain), the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) and patient rated tennis elbow evaluation (PRTEE). Results Seventeen of the 18 HA-injected patients (94%) completed the study. The average age was 51.9 years and 10 were male. Patients had an average of 28.1 months of pain before entering the study. VAS in the HA group improved from a baseline of 76.4 to 14.3 at 12 months. All 17 patients in the HA group showed VAS improvement above minimal clinically important difference (MCID) of at least 18. PRTEE improved from 67 to 28.1. QuickDASH improved from 53.7 to 22.5. To our knowledge, this improvement is greater than can be seen in any other non-surgical treatment for TE. Conclusions HA injections showed significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from injections of hyaluronic acid rather than having to undergo surgery.

scholarly journals Hyaluronic acid injections for chronic tennis elbow

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Gershon Zinger ◽  
Alexander Bregman ◽  
Ori Safran ◽  
Shaul Beyth ◽  
Amos Peyser
Keyword(s):  
Hyaluronic Acid ◽  
Tennis Elbow ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Saline Group ◽  
Primary Outcome Measure ◽  
Saline Control ◽  
Vas Score ◽  
One Year

Abstract Background For most patients, tennis elbow (TE) resolves within 6 months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatments for TE but have usually failed. In this study, we tested the hypothesis that injections with hyaluronic acid (HA) would be effective at reducing pain from chronic TE. Methods Patients with a minimum of six months of pain from TE and with a pain level of 50 or greater (out of 100) were included in the study. They were randomized equally into one of two treatment groups: injection with HA or injection with saline control. Follow-up was conducted at 3, 6 and 12 months from the initial injection. Both the patient and the examiner at the follow-up visits were blinded to the treatment arm. The primary outcome measure was the visual analog scale (VAS pain) score at one year. Additional outcome measures included the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and Patient Rated Tennis Elbow Evaluation (PRTEE) scores. Results Eighteen patients were randomized into the HA injection treatment arm, and 17 (94%) completed the study. The average age was 51.9 years, and 10 of the subjects were male. Patients had an average of 28.1 months of pain before entering the study. The VAS score in the HA group decreased from a baseline of 76.4–14.3 at 12 months. All 17 patients in the HA group showed VAS score reductions above the minimal clinically important difference (MCID) of at least 18. The PRTEE score improved from 67 to 28.1. The QuickDASH score improved from 53.7 to 22.5. Follow-up in the saline group was less than 50% and was therefore not used as a comparator. Conclusions HA injections yielded significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from receiving injections of hyaluronic acid rather than having to undergo surgery.

Tennis- und Golfer-Ellenbogen

2015 ◽  
Vol 63 (4) ◽  
Keyword(s):  
Spontaneous Recovery ◽  
Clinical Symptoms ◽  
Lateral Epicondylitis ◽  
High Rate ◽  
Evidence Based ◽  
Physical Methods ◽  
Local Injections ◽  
One Year ◽  
Golfer’S Elbow ◽  
Non Surgical Treatment

“Tennis and golfer’s elbow” are common pathologies due to overload of forearm extensors and flexors, and actually occur mostly outside tennis and golf sports. Several differential diagnoses of medial and lateral epicondylitis have to be excluded as there are a number of other conditions with similar clinical symptoms. The high rate of spontaneous recovery has to be considered in treatment. Evidence based conservative treatment comprises excentric physiotherapy, local injections, and physical methods. Surgery is reserved for patients with persistence of symptoms for more than one year despite non-surgical treatment.

scholarly journals Tooth Loss and Survival Analysis after Traumatic Injuries in Primary Dentition

2017 ◽  
Vol 21 (3) ◽  
pp. 146-151
Author(s):  
Jelena Galovic ◽  
Tatjana Vukojevic ◽  
Jelena Nikolic Ivosevic ◽  
Mirjana Perin ◽  
Kristina Vicko ◽  
...  
Keyword(s):  
Survival Rate ◽  
Primary Teeth ◽  
Treatment Options ◽  
Dental Trauma ◽  
Time Interval ◽  
Male Patients ◽  
One Year ◽  
The Moment ◽  
Novi Sad ◽  
Trauma Type

SummaryBackground/Aim: The aim of the present study was to investigate the treatment options, survival rate of traumatized primary teeth and evaluate the factors influencing the outcome. Material and Methods: The sample consisted of all dental trauma cases treated over a 14 years period at the Department of Pediatric and Preventive Dentistry, Dental Clinic of Vojvodina, Novi Sad. Criteria for inclusion in this study were: dental trauma to primary teeth and age in the moment of injury up to seven years. Dental trauma records were analyzed in order to obtain the following: gender and age of the child at the time of trauma, type of trauma, as well as the type and timing of treatment received. After data analysis a survival rate of traumatized primary teeth was evaluated. Results: The study was designed as retrospective and it included 225 children, with 346 traumatized primary teeth. The occurrence of trauma was higher in male patients (60,4%) and in children up to 4 years of age. Luxations were more frequent (72.8%) compared to isolated teeth fractures (20.8%), while the two types of injury combined were rare (6,3%). One year following dental trauma 231 teeth (0.67%) developed complications. Falls were the main cause of trauma (68.9%) and the presence of more than one traumatized tooth was frequent. A percentage of 48.8 children received dental care during first 24 h after the injury. Conclusions: Survival of injured primary teeth is relatively low, regardless of trauma type, time interval between injury and treatment and the type of provided treatment.

Lateral Epicondylitis: A Common Cause of Elbow Pain in Primary Care

2021 ◽  
pp. 34-38
Author(s):  
Jeffrey Fleming ◽  
Christian Muller Muller ◽  
Kathryn Lambert Lambert
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Tennis Elbow ◽  
Imaging Modality ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Repetitive Motion ◽  
Lateral Epicondyle ◽  
Magnetic Resonance Imaging Mri ◽  
Standard Radiographs

Lateral epicondylitis (LE) is an overuse injury of the lateral elbow. LE is caused by repetitive motion leading to micro-injury of the wrist extensor muscles that originate along the elbow's lateral aspect. Although LE is commonly referred to as “tennis elbow” many cases are observed in non-athletes. Due to its prevalence in the general population, primary care physicians must be prepared to diagnose and treat LE. Physicians should look for a history of repetitive activities involving patient’s jobs or recreational activities. Exam findings are characterized by pain and tenderness just distal to the lateral epicondyle of the humerus. Resisted movement with an extension of the wrist will typically elicit pain. Ultrasonography is considered the imaging modality of choice for diagnosing LE. Standard radiographs and magnetic resonance imaging (MRI) may be helpful. However, diagnosis can usually be made by history and physical examination alone. Most cases of LE respond favorably to conservative therapy. There are several nonoperative options for treatment, but a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy that utilizes eccentric muscle stretching is considered first-line. Osteopathic manipulative medicine is also useful in the treatment of LE. Muscle energy (ME) and joint mobilization techniques have been shown to be particularly effective. If non-surgical therapy fails, surgical intervention may provide patients with an additional benefit. This article will review some of the treatment options described above and discuss other diagnostic and therapeutic considerations relevant to LE's management in the primary care setting.

scholarly journals Treatment Outcome of Tennis Elbow by Percutaneous Needle Tenotomy

2013 ◽  
Vol 11 (2) ◽  
pp. 32-35
Author(s):  
Nirab Kayatha ◽  
Amit Joshi ◽  
Pankaj Chand ◽  
Bishnu Babu Thapa ◽  
Sushil Rana ◽  
...  
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Visual Analogue Score ◽  
Daily Practice ◽  
Hypodermic Needle ◽  
Painful Condition ◽  
Excellent Outcome ◽  
The Mean ◽  
Pain At Rest

Introduction: Tennis elbow (TE), or lateral epicondylitis of the humerus, is a painful condition seen commonly in the daily practice of Orthopaedic surgeons. One of the myriad of treatment methods for TE is percutaneous needle tenotomy of the common extensor origin. It is a simple operation with minimal morbidity and good-to-excellent results in most of the patients. The aim of this study was to evaluate the outcome in patients with chronic TE. Methods: this was a prospective study in 33 consecutive patients of both sexes with TE who were above 30 years of age. An 18 Gauge hypodermic needle was used under local anaesthesia to percutaneously tenotomise the extensor origin at the point of maximum tenderness. Visual analogue score (VAS) was used to assess the pain prior to intervention and in subsequent follow-ups at first, third, sixth and 12th weeks. Persistence of pain and return to activities of the patients was used to evaluate outcome as excellent, good, fair or poor. Results: At the end of 12 weeks, eleven out of 30 elbows (36.7%) had an excellent outcome, 13 (43.3%) had good, 5 (16.7%) had fair and 1 patient (3.3%) had poor outcome. At first week follow-up, the mean pain at rest was 4.60, the same at night was 2.73 and activity pain was a mean of 7.70 (max-9, min-5). By 12 week follow-up, the mean VAS scores at rest, night and activites were 0.87, 0.63 and 1.53 respectively, showing significant decrease in pain. Conclusions:Percutaneous tenotomy is a simple, safe, patient friendly, effective and easily reproducible method of treating tennis elbow.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/32-35 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7907

scholarly journals The three-portal technique in arthroscopic lateral epicondylitis release

2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Ashok Gowda ◽  
Gannon Kennedy ◽  
Stacey Gallacher ◽  
Jennie Garver ◽  
Theodore Blaine
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Arthroscopic Technique ◽  
Lateral Epicondyle ◽  
Extensor Muscles ◽  
The Common ◽  
One Year ◽  
Extensor Carpi Radialis ◽  
Portal Technique ◽  
Lower Morbidity

Lateral epicondylitis, commonly referred to as tennis elbow, is a syndrome characterized by pain over the origin of the common extensor muscles of the fingers, hand and wrist at the lateral epicondyle. Reports of 70-90% response to conservative treatment at one year have been documented in the literature though refractory cases often require surgical management. Arthroscopic treatment of lateral epicondylitis allows for intra-articular visualization for concomitant pathology and localization of the Extensor Carpi Radialis Brevis tendon. Additionally, compared to the open technique, the arthroscopic technique has a lower morbidity and an earlier return to work and activity. Here we describe a three portal technique for improved visualization in arthroscopic lateral epicondylitis release.

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 Autologus Blood Injection for Lateral Epicondylitis in Tertiary Level Hospital

2018 ◽  
Vol 26 ◽  
pp. 79-81
Author(s):  
DM Sohel ◽  
BK Dam ◽  
D Roy ◽  
MAK Shamsuddin ◽  
SK Pramanik
Keyword(s):  
Pain Score ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Injection Pain ◽  
Average Pain ◽  
Average Pain Score ◽  
Blood Injection ◽  
Level Hospital ◽  
Non Surgical Treatment

Tennis elbow is a common and well defined clinical entity. It is an extra articular affection characterised by pain and acute tenderness at the origin of the mainly extensorcarpi radialis brevis, but can involve the tendons of the extensorcarpi radialis longus and the extensor digitorum communis. It is also called lateral epicondylitis. Various types of treatment option for this disease that is conservative and operative. An injection of autologus blood might provide the necessary cellular and humoral mediators to induce a healing cascade. The purpose of the study was to evaluate result of epicondylitis treated with autologus blood injection.Total 19 patients with tennis elbow treated in this study.Among the patients 9 were male and 10 were female.Age of the patients were 25yrs – 60yrs, average 41.63yrs. All patients had failed previous non-surgical treatment. Duration of the pain 1 month to 6 months. All the patients got autologus blood injected every 21 days interval (one or three times). Before autologus blood injection average pain score was 6.2 and average Nirschi score was 5.8. After autologus blood injection pain score and Nirschi score decreases 2.2 and 2 respectively. Average follow-up period was 7 months.TAJ 2013; 26: 79-81

scholarly journals Reconstrucción de la papila interdental con ácido hialurónico. Artículo de Revisión Corto

2020 ◽  
Vol 12 (3) ◽  
pp. 212-216
Author(s):  
Jacinto José Alvarado Cordero ◽  
María Cristina Luna Pesántez ◽  
Eduardo Sebastián Cáceres Montalván
Keyword(s):  
Hyaluronic Acid ◽  
Surgical Treatment ◽  
Treatment Options ◽  
Less Invasive ◽  
Interdental Papilla ◽  
Non Surgical Treatment

One of the most frequent cosmetic dental problems is the presence of black triangles due to the loss of the interdental papilla. There are several surgical and non-surgical treatment options to correct this anomaly, among the most innovative and less invasive we found the use of an injectable gel of hyaluronic acid for the reconstruction of the interdental papilla. The objective of the study was to carry out a bibliographic compilation on the effectiveness of hyaluronic acid as a treatment for the reconstruction of the interdental papilla

Radial Shock Wave Therapy in Patients with Lateral Epicondylitis

Folia Medica ◽  
2012 ◽  
Vol 54 (3) ◽  
pp. 35-41 ◽  
Author(s):  
Elena M. Ilieva ◽  
Roumen M. Minchev ◽  
Nedyalka S. Petrova
Keyword(s):  
Shock Wave ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Functional Condition ◽  
Shock Wave Therapy ◽  
Therapeutic Modalities ◽  
Shockwave Therapy ◽  
The Past ◽  
One Year

ABSTRACT Introduction: Lateral epicondylitis, or “tennis elbow”, is a relatively common disorder. Various therapeutic modalities have been tried in an attempt to manage the disorder but neither the conservative methods nor the surgical options have proved to be benefi cial so far. During the past decade in the USA and European countries and the past several years in Bulgaria, the shock wave therapy (focused and radial) has been introduced as a method of choice in the treatment of chronic tendynopathies. The AIM of the present study was to make quantitative assessment of the effect of radial shockwave therapy in patients with lateral epicondylitis. PATIENTS AND METHODS: The study included 16 patients with lateral epicondylitis (9 males, 7 females, mean age 47.2 ± 2.3 yrs) of mean duration of 15.06 ± 4.06 months. We used the BTL-5000 radial shockwave therapy equipment and performed 5 procedures (one per week). The total number of shocks was 2500, the pressure was 2 Bars: 1500 shocks of 5 Hz frequency followed by 500 shocks of 10 Hz frequency were applied locally on the lateral epicondyle and 500 shocks of 2 Bar pressure and 5 Hz frequency were applied along the muscles near the insertion. The patients were evaluated 5 times: before treatment, immediately after the end of treatment and at 3, 6 and 12 months of follow-up. Pain was assessed at rest, on palpation and by the Thomsen test using a visual analogue scale (VAS). The patient-rated tennis elbow evaluation (PRTEE) questionnaire was used to assess the patients‘ pain, functional condition and limitations in performing specifi c activities, as well as for the overall self evaluation. RESULTS: We found signifi cant difference (p < 0.05) between the mean pain scores (at rest, on palpation and by Thomsen test) before treatment and these scores obtained immediately after treatment, the decrease sustained at 3, 6 and 12 months. VAS showed decrease from 3.75 ± 0.49 before therapy to 2.44 ± 0.39 after treatment, to 1.94 ± 0.46 at 3 months and to 0.69 ± 0.38 at one year at rest, from 7.44 ± 0.38 before therapy to 4.69 ± 0.51 after treatment, to 3.56 ± 0.40 at 3 months and 1.46 ± 0.56 at one year at palpation, and from 5.87 ± 0.46 before therapy to 3.5 ± 0.29 after it, to 2.5 ± 0.40 at 3 months and 1 ± 0.38 at one year in the Thomsen test. The pain, function and the total score as assessed on the patient-rated scale (PRTEE) also showed statistically signifi cant improvement (p < 0.05) after completion of therapy and over the whole follow-up. Total score decreased from 56.75 ± 2.34 before therapy to 39.38 ± 3.96 after treatment, to 27.53 ± 3.7 at 3 months and to 13.69 ± 4.48 at one year. CONCLUSION: Based on the results of this preliminary study we could recommend the radial shock wave therapy in the treatment of lateral epicondylitis of more than 6 months‘ duration if the condition is recalcitrant to other conservative methods of treatment.

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