Autologous Blood Injection Works for Recalcitrant Lateral Epicondylitis

Abstract

Background: Recalcitrant lateral epicondylitis may be a disabling condition. Treatment of this condition is still controversial. Aims: In the present prospective study, we evaluated the long-term results of autologous blood injection for the treatment of recalcitrant lateral epicondylitis. Study Design: Prospective clinical study. Methods: A total of 42 elbows of 40 consecutive patients (28 female, 12 male) were enrolled in this prospective study. Seven patients left the study (3 patients moved to another city, 1 patient died in the second week due to a heart condition, 1 patient quit the study because of the resolution of pain in the fourth week and 2 patients did not agree to the second injection). Thirteen patients were lost to third year follow-up. Therefore, a total of 21 elbows of 20 patients with 3 years of follow-up were included in this study. The mean age of the patients was 47.25 years (range, 20-68 years).   Results: Visual analogue scale (VAS), Nirschl score and grip strength were significantly improved after injections when compared to before treatment. The best improvement in terms of grip strength, Nirschl score and VAS score was detected at the one year follow-up. The improvement in Nirschl and VAS score sustained until the third year. Conclusion: We suggest that autologous blood injection for the treatment of recalcitrant lateral epicondylitis is an effective, safe and successful procedure in the long-term.

Keywords

• Autologous blood, tennis elbow, lateral epicondylitis

References

1. 1. Xu Y, Murrell GA. The basic science of tendinopathy. Clin Orthop Relat Res 2008;466:1528-38. [CrossRef]
2. 2. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 2006;34:1774-8. [CrossRef]
3. 3. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow: A randomized, double blinded, placebo controlled clinical trial. Am J Sports Med 2003;31:915-20.
4. 4. Struijs PA, Kerkhoffs GM, Assendelft WJ, Van Dijk CN. Conservative treatment of lateral epicondylitis: Brace versus physical therapy or a combination of both- A randomized clinical trial. Am J Sports Med 2004;32:462-9. [CrossRef]
5. 5. Mullett H, Sprague M, Brown G, Hausman M. Arthroscopic treatment of lateral epicondylitis: Clinical and cadaveric study. Clin Orthop Relat Res 2005;439:123-8. [CrossRef]
6. 6. Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, et al. Non-steroidal anti-inflammatory drugs (NSAID) for treating lateral elbow pain in adults. Cochrane Database Syst Rev 2001;4:1-18. [CrossRef]
7. 7. Smidt N, Assendelft WJ, van der Windt DA, Hay EM, Buchbinder R, Bouter LM. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain 2002;96:23-40. [CrossRef]
8. 8. 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;36:1269-72. [CrossRef]

9. 9. Dojode CM. A randomized control trial to evaluate the efficacy of autologous blood injection versus local corticosteroid injection for the treatment of lateral epicondylitis. Bone Joint Res 2012;1:192-7. [CrossRef]
10. 10. Jindal N, Gaury Y, Banshiwal RC, Lamoria R, Bachhal V. Comparison of short term results of single injections of autologous blood and steroid injection in tennis elbow: a prospective study. J Orthop Surg Res 2013;8:1-7. [CrossRef]
11. 11. Edwards SG, Calandruccio JH. Autologous blood injection for refractory lateral epicondylitis. J Hand Surg Am 2003;28:272-8. [CrossRef]
12. 12. Connell DA, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M. Ultrasound-guided autologous blood injection for tennis elbow. Skeletal Radiol 2006;35:371-7. [CrossRef]
13. 13. Nirschl RP. Elbow tendinosis/tennis elbow. Clin Sports Med 1992;11:851-70.
14. 14. James SL, Ali K, Pocock C, Robertson C, Walter J, Bell J, et al. Ultrasound guided dry needling and autologous blood injection for patellar tendinosis. Br J Sports Med 2007;41:518-21. [CrossRef]
15. 15. Suresh SP, Ali KE, Connell DA. Medial epicondylitis: is ultrasound guided autologous blood injection an effective treatment. Br J Sports Med 2006;40:935-9. [CrossRef]
16. 16. Massy-Westropp N, Simmonds S, Caragianis S, Potter A. Autologous blood injection and wrist immobilization for chronic lateral epicondylitis. Adv Orthop 2012;2012:387829.
17. 17. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaoua A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral epicondylitis: a randomized controlled clinical trial. Am J Sports Med 2011;39:2130-4. [CrossRef]