Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

作者：Nicola Massy Westropp; Stuart Simmonds; Suzanne Caragianis; Andrew Potter

来源：Advances in Orthopedics, 2012.

DOI：10.1155/2012/387829

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每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. 1. Introduction Lateral epicondylitis or tennis elbow is a common condition that causes pain on the outside of the elbow, as well as pain and weakness during gripping. It has been found to occur in approximately 1.3% of people in studied populations [1]. Tennis elbow is commonly associated with obesity, smoking, and physical loading during activity, as well as playing tennis [1]. The site of long-term scarring has been shown (during ultrasound) to be where the extensor carpi radialis brevis muscle, which lifts the wrist, originates from the humerus [2]. There are many conservative treatments, including splinting, massage, injection of nonsteroidal anti-inflammatories, and alteration of tasks performed by the patient. There is high level, high quality evidence to suggest that extracorporeal shock wave therapy has little or no benefit [3] and that the evidence for orthotics and splints is not clear [4], but a high number of studies suggest that injection of nonsteroidal anti-inflammatories provides good immediate pain relief, with variable recurrence rates of symptoms [4]. Corticosteroid injection has been shown to provide short-term relief but relapse rates are high [5]. Autologous blood injection (ABI) is theorized to stimulate a

• 出版日期2012