Effectiveness of local injection of autologous blood versus corticosteroid in treatment of tennis elbow

T. Prasai, Krishna Raj Khanal, Nanda Kishor Shah, R. Pradhan, Bimal Kumar Pandey
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Abstract

Background: Tennis elbow or lateral epicondylitis is characterised by pain and tenderness at the lateral epicondyle of humerus. There are various treatment modalities recommended, but there is no universally accepted therapeutic modality yet. Objectives: To compare the functional outcomes of local injection of corticosteroid versus autologous whole blood for tennis elbow. Methods: This was a non-randomised trial conducted from May 2020 to January 2021 after ethical clearance. Patients attending orthopaedic surgery outpatient department, Kathmandu Medical College with lateral epicondylitis of the humerus were included by convenience sampling into corticosteroid group or autologous blood injection group based on whether they presented on odd or even calendar days respectively. There were 38 patients in corticosteroid group and 36 patients in autologous blood group. The visual analogue scale (VAS) and Nirschl staging system were calculated before injection, and then at one week, six weeks, and six months after injection. Results: Patients in both groups showed statistically significant decrease in pain from preinjection scores on both VAS and Nirschl scale at all follow-ups. There was no statistically significant difference between the two groups up to six weeks. At six months, autologous blood injection group showed statistically significant decrease in pain compared with corticosteroid injection group on both scoring systems. Conclusion: Both groups showed comparable improvement up to six-week follow-up. Autologous blood injection group had significantly better improvement at six months. Autologous blood injection was more effective than corticosteroid injection at midterm follow-up, and had lower recurrence rate.
局部注射自体血与皮质类固醇治疗网球肘的疗效比较
背景:网球肘或外上髁炎以肱骨外上髁疼痛和压痛为特征。目前推荐的治疗方式多种多样,但还没有一种被普遍接受的治疗方式。目的:比较局部注射皮质类固醇与自体全血治疗网球肘的功能效果。方法:这是一项非随机试验,经伦理许可,于2020年5月至2021年1月进行。在加德满都医学院骨科门诊部就诊的肱骨外上髁炎患者,根据就诊日期为单日还是双日,采用方便抽样的方法分为皮质类固醇组和自体血液注射组。糖皮质激素组38例,自体血组36例。分别于注射前、注射后1周、6周、6个月计算视觉模拟评分(VAS)和Nirschl分期。结果:在所有随访中,两组患者在注射前VAS评分和Nirschl评分中疼痛均有统计学意义的降低。两组在6周内没有统计学上的显著差异。6个月时,与皮质类固醇注射组相比,自体血液注射组在两种评分系统上的疼痛均有统计学意义的减轻。结论:两组在6周的随访中均有相当的改善。自体血液注射组在6个月时改善明显。中期随访时,自体血注射比皮质类固醇注射更有效,复发率更低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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