scholarly journals Current Trends for Treating Lateral Epicondylitis

2019 ◽  
Vol 22 (4) ◽  
pp. 227-234
Author(s):  
Gyeong Min Kim ◽  
Seung Jin Yoo ◽  
Sungwook Choi ◽  
Yong-Geun Park
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Blood Platelet ◽  
Functional Improvement ◽  
Therapeutic Trials ◽  
Current Trends ◽  
Interventional Therapies

Lateral epicondylitis, also known as ‘tennis elbow’, is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.

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 The effects of regenerative injection therapy compared to corticosteroids for the treatment of lateral Epicondylitis: a systematic review and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Julie Barnett ◽  
Madison N. Bernacki ◽  
Jessica L. Kainer ◽  
Hannah N. Smith ◽  
Annette M. Zaharoff ◽  
...  
Keyword(s):  
English Language ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Functional Limitations ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Risk Of Bias ◽  
Injection Therapy ◽  
Lateral Epicondyle

Abstract Background The lateral epicondyle is a common site for chronic tendinosis (i.e. lateral epicondylitis), a condition characterized by overuse and degeneration of a tendon due to repeated microtrauma. This leads to pain and functional limitations. There is a growing interest in non-surgical forms of treatment for this condition including provision of corticosteroid injections and regenerative injection therapy (provision of autologous blood and platelet rich plasma injections). Objective We compared the effectiveness of corticosteroids with regenerative injection therapy for the treatment of lateral epicondylitis. Methods We systematically reviewed randomized controlled trials published in English language from 2008 to 2018. Databases used included PEDro, Scopus, PubMed, and CINAHL. Nine articles met our selection criteria. The PEDRo scale scores helped assess study quality. Cochrane risk of bias criteria helped assess bias. We analyzed results focusing on pain and function using meta-analyses. Results Six out of 9 studies had low risk of bias. There were no short-term (1 and 2 month) differences in pain scores between the corticosteroid and regenerative injection groups. Participants receiving regenerative injections demonstrated greater long-term improvements lasting for a period of ≈2 years. Conclusion Regenerative injections provision results in greater long–term pain relief and improved function for people with lateral epicondylitis.

Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis

2017 ◽  
Vol 3 (1) ◽  
pp. 1-5
Author(s):  
KM Gopinath ◽  
Madhuram Chowdry ◽  
BNR Kumar ◽  
TR Kanmani
Keyword(s):  
Comparative Study ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Tertiary Care ◽  
Disease Process ◽  
Lateral Epicondylitis ◽  
Care Hospital

ABSTRACT Introduction Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies. In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis. Materials and methods A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care – Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention. Results Steroid treatment shows better outcome in short-term (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores – visual analog score (VAS), DASH, Nirschl – showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection. Conclusion Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP. How to cite this article Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.

scholarly journals TENNIS ELBOW

2018 ◽  
Vol 25 (02) ◽  
pp. 196-200
Author(s):  
Usama Bin Saeed ◽  
Talha Bind Saeed ◽  
Sundus Tariq
Keyword(s):  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Lateral Epicondylitis ◽  
Root Cause ◽  
Repetitive Movements ◽  
Significant Disability ◽  
Group A ◽  
Group B

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.

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.

scholarly journals Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Nicola Massy-Westropp ◽  
Stuart Simmonds ◽  
Suzanne Caragianis ◽  
Andrew Potter
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Contralateral Limb ◽  
Cortisone Injection ◽  
Autologous Blood Injection ◽  
Blood Injection ◽  
And Function ◽  
Prospective Longitudinal ◽  
Extensor Carpi Radialis

Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

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

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