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

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.

Author(s):  
Vikram Sharma ◽  
Vivek Chandak

<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>


2014 ◽  
Vol 3 (2) ◽  
pp. 36-40
Author(s):  
Jetindar Puri ◽  
Dr Nabiha Ahmed

OBJECTIVE To compare the effects of deep friction massage and ultrasound therapy in subjects with tennis elbow in terms of pain, grip strength and functional activities. STUDY DESIGN Randomized Control Trial. STUDY SETTINGS AND PARTICIPANTS Study was conducted in Physiotherapy OPD of a tertiary care hospital. A sample of 50 patients were inducted in the study. Sample size calculated through open Epi calculator. OUTCOME MEASURES Patients with the diagnosed lateral epicondylitis (Tennis elbow) presenting to out Patient department of two tertiary care hospitals has been enrolled for study after written informed consent. Subjects were randomly allocated into two groups i.e. group A and group B. Group A = DFM + exercise, Group B = U/S + exercise. RESULTS Total 50 patients were randomized and divided into two groups. Group A: the mean pain score on VAS before treatment was 5.88±1.130 and after treatment 1.80±1.041 p-value=0.006. Group B: the mean pain score on VAS before treatment was 6.56±1.446 and after treatment was 2.72±1.208 p-value=0.006. Group A: the mean grip strength score was 13.92±2.691 and in after treatment was 19.60±5.454 p-value=0.342. Group B: the mean grip strength was 15.12±2.505 and after treatment was 20.92±4.183p-value=0.342. CONCLUSION The present study showed no statistical difference in using deep frictional massage therapy in relieving pain, improving grip strength and functional performance in subject with tennis elbow. KEY WORDS Tennis Elbow, Lateral Epicondylitis, Deep Friction Massage, Hand Held Dynamometer, Ultrasound Therapy, Grip Strength.


2020 ◽  
Vol 15 (2) ◽  
pp. 35-39
Author(s):  
Mohammed Sh. Al-Edanni

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)


2016 ◽  
Vol 5 (1) ◽  
pp. 45-51
Author(s):  
Fareeda Shaheen ◽  
Nazish Rafique ◽  
Aqsa Izhar Ahmed ◽  
Perkash Lal

OBJECTIVES To compare the effect of Mobilization with Movement (MWM) and Manipulation in the management of lateral epicondylitis with regard to ache, grip power and functional activities. METHODOLOGY 20 patients presented with lateral epicondylitis (Tennis elbow) to OPD in Ziauddin Hospital (Clifton, North and Kemari campuses). They were enrolled for the purpose of research study after written informed consent. Subjects were erratically assigned into 2 groups, i.e. group A for MWM and group B for manipulation. All patients were examined before and after the treatment and then findings were evaluated. Pain was sedated by Visual analogue scale (VAS), grip strength was measured by hand–held dynamometer and functional activities’ outcomes were measured by forearm analysis questionnaire survey for lateral epicondylitis, by H B Leung et al 2004. RESULT A total of 20 patients were randomly selected and divided into two groups i.e. Group–A & Group–B. The result shows for Group A: The mean of pain score on VAS before treatment was 4.70±1.418 while after treatment was 0.10±0.316 with P value (0.05) and the mean of grip strength score before treatment was 13.40±7.442 while after treatment was 22.60±8.501. For Group B: The mean of pain score on VAS before treatment was 5.20±0.632 while after treatment was 0.5±0.527 with P value (0.05) and the mean of grip strength before treatment was 26.20±21.028 and after treatment was 32.00±24.33. CONCLUSION This study shows evidence to support the effectiveness of both approaches (MWM + Manipulation) for relieving ache, strengthening and functionality along with tennis elbow. KEYWORDS Lateral epicondylitis, Manipulation, Mobilization with movement (MWM), dynamometer, visual analog scale, and analysis.


2020 ◽  
Vol 18 (1) ◽  
pp. 15-17
Author(s):  
Gopal Sagar DC

Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.


Author(s):  
Hassan Amir Us Saqlain ◽  
Syed Sajid Hussain ◽  
Niaz Hussain Keerio ◽  
Masood Ahmed Qureshi ◽  
Nuresh Kumar Valecha ◽  
...  

Objective: This study aims to evaluate the effect of platelet rich plasma (PRP) and compare between single and double dose regimens among patients diagnosed with osteoarthritis admitted to the orthopedic department of Al Qassimi Hospital Sharjah, United Arab Emirates. Methods: 200 patients were allocated into two groups in this randomized clinical trial. Patients were chosen to participate in this study after an informed consent. The trial took place at the Al Qassimi Hospital Sharjah, United Arab Emirates from July 2019 to July 2020. All patients had knee osteoarthritis, half of them received single dose PRP (group A) and the other half received double dose PRP (group B). All patients were adults and older than 18 years of age. Patients were followed up using Western Ontario and McMaster Universities Arthritis Index (WOMAC). The follow up was done prior to the administration of PRP, at 1 month, 3 month and 6 months after administration. Data was analyzed using SPSS program. Ethical approval was gained from the hospital as well as from patients. Results: The mean age of the patients was 48.5 ± 8.3 years. The study included 200 participants, among them, 60 were females and 140 were males. There was improvements in all parameters of WOMAC at 3 and 4 weeks following administration of PRP. The effect of PRP continued until 6 months of follow up with no differences between the two groups. Group A baseline WOMAC parameters (pain, stiffness, physical function and total score) mean score were 15.8, 6.24, 43.01 and 65.22 respectively. At the follow up, the mean scores were 4.73, 1.78, 13.88 and 19.56 respectively. This shows significant improvement. On the other hand, group B baseline mean scores were 16.31, 6.81, 40.89 and 64.77 respectively. At the final follow up of group B, the parameters mean scores were 4.40, 1.11, 13.64 and 20.27 respectively. Both groups were compared to each other and no benefit for the double dose over the single dose (P value, 0.66). Conclusion: Previous results suggests improvement in functionality in both groups of the trial. There was pain and stiffness relief among all patients. It is concluded that double dose has no additional effect to the single dose regimen.


2018 ◽  
Vol 25 (02) ◽  
pp. 196-200
Author(s):  
Usama Bin Saeed ◽  
Talha Bind Saeed ◽  
Sundus Tariq

Introduction: Lateral epicondylitis, also called as Tennis Elbow is the primarycause of musculo-skeletal ache including extensor origin of forearm. Repetitive movements areconsidered to be the root cause of this disorder. This disorder involves overexertion of fingers andwrist extensors that causes significant disability ultimately affecting the quality of life. The basisfor diagnosing lateral epicondylitis is very clear clinically. The strategy of injecting steroid locallyhas proven to dispense predictable and consistent transient relief of pain. Recent treatmentinvolve Platelet Rich Plasma (PRP) administration locally. Study Design: Prospective study.Period: 01-07-2014 to 30-06-2016. Setting: Department of Orthopedic Surgery Allied /DHQHospital Faisalabad. Subject and Methods: Total of 38 patients aging 25-60 years belongingto either gender with Lateral Epicondylitis who met inclusion criteria were enrolled in this studyand divided in two (2) groups A and B. The group which was treated with steroid injection waslabeled as A and group B comprised of patients which were treated with prepared PRP injection.Outcome was analyzed on the basis of Visual Analogue Scale of pain and functional outcomeusing qDash scores at baseline, 6 weeks and 12 weeks. Results: In Group A, baseline VASwas 7.3 + 2.1 and q DASH was 83+1.2. At 6 weeks and 12 weeks VAS was 5.3+ 3.1 and 6.1+1.2 respectively. qDash scores were 78 + 4.2 and 63 + 1.6 at 6 and 12 weeks respectively.In Group B VAS was 7.2+ 2.2, 5.3 +1.3, 3.2+ 1.2 at baseline, 6 weeks and 12 weeks. WhileqDash Scores were 81+3.2, 74+3.7, 58+1.2 at baseline, 6 weeks and 12 weeks respectively.Conclusion: Steroid and PRP are effective equally for treating lateral epicondylitis. Accordingto this study, PRP is ranked superior to steroid for its long term effectiveness in controlling painand improve functional outcome.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.


2021 ◽  
Vol 8 (12) ◽  
pp. 1817
Author(s):  
Vishal Kumar Gupta ◽  
Richa Giri ◽  
Saurabh Agrawal

Background: Dipeptidyl peptidase (DPP)-4 inhibitors, anti-diabetic agents, are expected to be effective for treatment of non-alcoholic fatty liver disease (NAFLD). Several studies have shown that some DPP-4 inhibitors alleviate hepatic steatosis or steatohepatitis in type 2 diabetic mice or rats. Teneligliptin is DPP4 inhibitor whose efficacy to control blood sugar is well established but its effect on liver is not studied well. In present study we investigated effect of teneligliptin, a DPP-4 inhibitor on patients of type 2 diabetes with non-alcoholic steatohepatitis (NASH). Methods: This was a randomized, double-blind study in which 64 patients between ages of 18 to 80 years were selected for study. Participants were identified as type 2 diabetes with biopsy confirmed NASH. We excluded the patients with glucocorticoid use, hepatitis B or C, and other diseases that might affect liver function. Results: The mean HbA1c change after 48 weeks of therapy in group A was-1.06 % and in group B was-0.77% and this was statistically insignificant (p>0.06). The mean AST change after 48 weeks of therapy in group A was-45.4% and in group B was-33.3% and this was statistically significant (p<0.001). The mean ALT change after 48 weeks of therapy in group A was-41.6% and in group B was-22.7% and this was statistically significant (p<0.001). The change in liver fat content (LFC) after 48 weeks of therapy in group A was-15.4% and group B was-7.14% and this was also statistically significant (p<0.001).Conclusions: Result of our study revealed that teneligliptin significantly reduce serum transaminases in patients of NASH with type 2 DM. Teneligliptin significantly reduce LFC and delay progression of NASH independent of diabetes control in type 2 diabetes mellitus (DM) patients. These data show significant antisteatotic and anti-inflammatory effect of teneligliptin in type 2 diabetes patients.


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