INJECTION OF AUTOLOGOUS WHOLE BLOOD VERSUS CORTICOSTEROID FOR LATERAL EPICONDYLITIS: A COMPARATIVE STUDY
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i12.49952Keywords:
Tennis elbow, Lateral epicondylitis, Autologous whole blood, CorticosteroidsAbstract
Objective: The objective is to compare the efficacy, in terms of pain relief and functional improvement, of autologous whole blood and corticosteroid injection in managing lateral epicondylitis (Tennis elbow).
Methods: This was a comparative study conducted in Department of Orthopedics, National Institute of Medical Sciences Jaipur, Rajasthan, India. Eighty patients diagnosed to be having lateral epicondylitis were included in this study on the basis of predefined inclusion and exclusion criteria. The patients were divided into 2 groups on the basis of whether they were given autologous whole blood (Group B) or corticosteroid injection (Group S). Efficacy of both the treatment modality was compared in terms of Pain relief (as assessed by reduction in visual analogue score [VAS] score) and functional improvement (as assessed by improvement in Mayo Elbow performance score). SSPS 22.0 software was used for statistical analysis and p<0.05 was taken as statistically significant.
Results: A total of 80 patients were included in this study out of which there were 37 (46.25%) males and 43 (53.75%) females with a M: F ratio of 1:1.16. The mean age of patients in group B and group S was found to be found to be 52.36±9.98 years and 48.46±10.12 years, respectively. The mean age of patients in both the groups was found to be comparable with no statistically significant difference (p=0.0866). At the time of 4 weeks, 8 weeks, and 12 weeks follow–up, the mean VAS score in Group B was less as compared to group S and the difference was found to be statistically highly significant (p<0.0001). At the time of 4 weeks, 8 weeks, and 12 weeks’ follow-up, the mean MEPS in Group B was more as compared to group S, and the difference was found to be statistically significant (p<0.05).
Conclusion: For lateral epicondylitis, whole blood injection demonstrated superior efficacy in terms of pain relief and functional improvement as compared to injection of corticosteroid.
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References
Buchanan BK, Varacallo M. Lateral epicondylitis (Tennis Elbow). In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023.
Vaquero-Picado A, Barco R, Antuña SA. Lateral epicondylitis of the elbow. EFORT Open Rev 2017;1:391-7. doi: 10.1302/2058- 5241.1.000049
De Smedt T, de Jong A, Van Leemput W, Lieven D, Van Glabbeek F. Lateral epicondylitis in tennis: Update on aetiology, biomechanics and treatment. Br J Sports Med 2007;41:816-9. doi: 10.1136/ bjsm.2007.036723
Kotnis NA, Chiavaras MM, Harish S. Lateral epicondylitis and beyond: Imaging of lateral elbow pain with clinical-radiologic correlation. Skeletal Radiol 2012;41:369-86. doi: 10.1007/s00256-011-1343-8
Calfee RP, Patel A, DaSilva MF, Akelman E. Management of lateral epicondylitis: Current concepts. J Am Acad Orthop Surg 2008;16:19-29. doi: 10.5435/00124635-200801000-00004
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;7:2325967119831052. doi: 10.1177/2325967119831052
Bisset L, Coombes B, Vicenzino B. Tennis elbow. BMJ Clin Evid 2011;2011:1117.
Di Filippo L, Vincenzi S, Pennella D, Maselli F. Treatment, diagnostic criteria and variability of terminology for lateral elbow pain: Findings from an overview of systematic reviews. Healthcare (Basel) 2022;10:1095. doi: 10.3390/healthcare10061095
Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev 2018;2:e088. doi: 10.5435/ JAAOSGlobal-D-17-00088
Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg Am 2014;39:1146-50. doi: 10.1016/j. jhsa.2014.01.041
Cutts S, Gangoo S, Modi N, Pasapula C. Tennis elbow: A clinical review article. J Orthop 2019;17:203-7. doi: 10.1016/j.jor.2019.08.005
Kaminsky SB, Baker CL Jr. Lateral epicondylitis of the elbow. Tech Hand Up Extrem Surg 2003;7:179-89. doi: 10.1097/00130911- 200312000-00009
Ahmad Z, Siddiqui N, Malik SS, Abdus-Samee M, Tytherleigh- Strong G, Rushton N. Lateral epicondylitis: A review of pathology and management. Bone Joint J 2013;95-B:1158-64. doi: 10.1302/0301-620X.95B9.29285
Luk JK, Tsang RC, Leung HB. Lateral epicondylalgia: Midlife crisis of a tendon. Hong Kong Med J 2014;20:145-51. doi: 10.12809/ hkmj134110
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;22:333-7. doi: 10.1177/230949901402200313
Kaya SS, Yardımcı G, Göksu H, Genç H. Effects of splinting and three injection therapies (corticosteroid, autologous blood and prolotherapy) on pain, grip strength, and functionality in patients with lateral epicondylitis. Turk J Phys Med Rehabil 2022;68:205-13. doi: 10.5606/ tftrd.2022.8007
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;17:101-12. doi: 10.1007/s10195-015-0376-5
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;8:10. doi: 10.1186/1749-799X-8-10
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;89:660-7. doi: 10.1097/ PHM.0b013e3181ddcb31
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 2011;36A:1269-72.
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