Subscribe to RSS
DOI: 10.1055/s-0040-1716991
Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis
Abstract
Lateral 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.
Publication History
Article published online:
17 September 2020
© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Arirachakaran A, Sukthuayat A, Sisayanarane T, Laoratanavoraphong S, Kanchanatawan W, Kongtharvonskul J. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis. J Orthop Traumatol 2016; 17 (02) 101-112
- 2 Vincent JI, MacDermid JC, King GJW, Grewal R. The patient-rated elbow evaluation and the american shoulder and elbow surgeons -elbow form capture aspects of functioning that are important to patients with elbow injuries. J Hand Ther 2020; Doi: DOI: 10.1016/j.jht.2020.02.001.
- 3 Lee JH, Lee SH. Lateral antebrachial cutaneous neuropathy after steroid injection at lateral epicondyle. J Back Musculoskeletal Rehabil 2015; 28 (02) 419-422
- 4 Keijsers R, van den Bekerom MPJ, Koenraadt KLM, Bleys RLAW, van Dijk CN, Eygendaal D. Elbow Study Collaborative. Injection of tennis elbow: hit and miss? A cadaveric study of injection accuracy. Knee Surg Sports Traumatol Arthrosc 2017; 25 (07) 2289-2292
- 5 Malahias MA, Kaseta MK, Kazas ST, Megaloikonomos PD, Mavrogenis AF, Babis GC. Image-guided versus palpation-guided injections for the treatment of chronic lateral epicondylopathy: a randomized controlled clinical trial. Handchir Mikrochir Plast Chir 2018; 50 (05) 348-352
- 6 Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am 2003; 28 (02) 272-278
- 7 Martin JI, Merino J, Atilano L. et al Platelet-rich plasma (PRP) in chronic epicondylitis: study protocol for a randomized controlled trial. Trials 2013; 14: 410
- 8 Chen X, Jones IA, Park C, Vangsness Jr CT. The efficacy of platelet-rich plasma on tendon and ligament healing: a systematic review and meta-analysis with bias assessment. Am J Sports Med 2018; 46 (08) 2020-2032
- 9 Tang S, Wang X, Wu P, Wu P, Yang J, Du Z, Liu S, Wei F. Platelet-rich plasma vs autologous blood vs corticosteroid injections in the treatment of lateral epicondylitis: a systematic review, pairwise and network meta-analysis of randomized controlled trials. 2019; Doi: DOI: 10.1002/pmrj.12287.
- 10 Houck DA, Kraeutler MJ, Thornton LB, McCarty EC, Bravman JT. Treatment of lateral epicondylitis with autologous blood, platelet-rich plasma, or corticosteroid injections: a systematic review of overlapping meta-analyses. Orthop J Sports Med 2019; 7 (03) 2325967119831052
- 11 Jindal N, Gaury Y, Banshiwal RC, Lamoria R, Bachhal V. Comparison of short term results of single injection of autologous blood and steroid injection in tennis elbow: a prospective study. J Orthop Surg Res 2013; Doi: DOI: 10.1186/1749-799X-8-10.
- 12 Kazemi M, Azma K, Tavana B, Rezaiee Moghaddam F, Panahi A. Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy. Am J Phys Med Rehabil 2010; 89 (08) 660-667
- 13 Arik HO, Kose O, Guler F, Deniz G, Egerci OF, Ucar M. Injection of autologous blood versus corticosteroid for lateral epicondylitis: a randomised controlled study. J Orthop Surg (Hong Kong) 2014; 22 (03) 333-337
- 14 Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. Platelet-rich therapies for musculoskeletal soft tissue injuries. Cochrane Database Syst Rev 2014; 4 (04) CD010071
- 15 Linnanmäki L, Kanto K, Karjalainen T, Leppänen OV, Lehtinen J. Platelet-rich plasma or autologous blood do not reduce pain or improve function in patients with lateral epicondylitis: a randomized controlled trial. Clin Orthop Relat Res 2020; 478 (08) 1892-1900
- 16 Wolf JM, Ozer K, Scott F, Gordon MJ, Williams AE. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am 2011; 36 (08) 1269-1272
- 17 Uygur E, Aktaş B, Özkut A, Erinç S, Yilmazoglu EG. Dry needling in lateral epicondylitis: a prospective controlled study. Int Orthop 2017; 41 (11) 2321-2325
- 18 de RJ Vos, Windt J, Weir A. Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review. Br J Sports Med 2014; 48 (12) 952-956