Autologous Blood Versus Corticosteroid Local Injection in the Short-Term Treatment of Lateral Elbow Tendinopathy

Kazemi, M; Azma, Kamran; Tavana, Behrooz; Moghaddam, Farid Rezaiee; Panahi, Ali

doi:10.1097/phm.0b013e3181ddcb31

Cited by 107 publications

(93 citation statements)

References 25 publications

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“…20,21 In a review of 12 studies for treatment of lateral epicondylitis, the use of autologous blood, corticosteroid, platelet-rich plasma, placebo, or extracorporeal shock wave therapy were compared (Table 3). 6,13,14,[22][23][24][25][26][27][28][29][30] Autologous blood injection was more effective in the long term than corticosteroid injection in improving pain and tenderness, although corticosteroid injection enabled faster pain relief. Extracorporeal shock wave therapy was also more effective than corticosteroid injection in the long term.…”

Section: Discussionmentioning

confidence: 99%

Injection of Autologous Blood versus Corticosteroid for Lateral Epicondylitis: A Randomised Controlled Study

Arik

Köse

Güler

et al. 2014

J Orthop Surg (Hong Kong)

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Purpose.To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral epicondylitis. Methods. 21 men and 59 women (mean age, 45.2 years) presenting with lateral epicondylitis were randomised to receive either autologous blood injection (2 ml of autologous venous blood mixed with 1 ml of 2% prilocaine hydrochloride) or corticosteroid injection (1 ml of 40 mg methylprednisolone acetate mixed with 1 ml of 2% prilocaine hydrochloride) given by a single physician. Patients were assessed before (day 0) and after (days 15, 30, and 90) treatment for elbow pain (using a visual analogue scale [VAS]), function (using the patient-rated tennis elbow evaluation [PRTEE] questionnaire), and grip strength (using a hydraulic hand dynamometer). Patients were followed up at 6 months by telephone to assess elbow pain using the VAS. Results. No complications (infection, skin atrophy, neurovascular damage, or tendon rupture) were

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Section: Discussionmentioning

confidence: 99%

Injection of Autologous Blood versus Corticosteroid for Lateral Epicondylitis: A Randomised Controlled Study

Arik

Köse

Güler

et al. 2014

J Orthop Surg (Hong Kong)

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“…However, given the need to update the systematic reviews on which these findings are based, 56,60 and the subsequent publication of 10 new RCTs, 165,168,169,173,176,181,183,184,191,193 the overall level of evidence, as determined using the GRADE principles, is low (see Table 24). All of the subsequent RCTs were head-to-head comparisons, and all but one study (Gosens et al,…”

Section: Glucocorticoid Injectionsmentioning

confidence: 99%

“…18,[167][168][169][170][172][173][174][175][176][177][178][179][180][181][182][183][184][185][188][189][190][191][192][193][194][195][196][197][198] The majority of studies had small sample sizes (≤ 50 participants, n = 18; 51-100 participants, n = 15; > 100 participants, n = 3).…”

Section: Randomised Controlled Trials Not Included In An Existing Sysmentioning

confidence: 99%

What is the clinical effectiveness and cost-effectiveness of conservative interventions for tendinopathy? An overview of systematic reviews of clinical effectiveness and systematic review of economic evaluations

Long

Briscoe

Cooper

et al. 2015

Health Technology Assessment

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BackgroundLateral elbow tendinopathy (LET) is a common complaint causing characteristic pain in the lateral elbow and upper forearm, and tenderness of the forearm extensor muscles. It is thought to be an overuse injury and can have a major impact on the patient’s social and professional life. The condition is challenging to treat and prone to recurrent episodes. The average duration of a typical episode ranges from 6 to 24 months, with most (89%) reporting recovery by 1 year.ObjectivesThis systematic review aims to summarise the evidence concerning the clinical effectiveness and cost-effectiveness of conservative interventions for LET.Data sourcesA comprehensive search was conducted from database inception to 2012 in a range of databases including MEDLINE, EMBASE and Cochrane Databases.Methods and outcomesWe conducted an overview of systematic reviews to summarise the current evidence concerning the clinical effectiveness and a systematic review for the cost-effectiveness of conservative interventions for LET. We identified additional randomised controlled trials (RCTs) that could contribute further evidence to existing systematic reviews. We searched MEDLINE, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science, The Cochrane Library and other important databases from inception to January 2013.ResultsA total of 29 systematic reviews published since 2003 matched our inclusion criteria. These were quality appraised using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist; five were considered high quality and evaluated using a Grading of Recommendations, Assessment, Development and Evaluation approach. A total of 36 RCTs were identified that were not included in a systematic review and 29 RCTs were identified that had only been evaluated in an included systematic review of intermediate/low quality. These were then mapped to existing systematic reviews where further evidence could provide updates. Two economic evaluations were identified.LimitationsThe summary of findings from the review was based only on high-quality evidence (scoring of > 5 AMSTAR). Other limitations were that identified RCTs were not quality appraised and dichotomous outcomes were also not considered. Economic evaluations took effectiveness estimates from trials that had small sample sizes leading to uncertainty surrounding the effect sizes reported. This, in turn, led to uncertainty of the reported cost-effectiveness and, as such, no robust recommendations could be made in this respect.ConclusionsClinical effectiveness evidence from the high-quality systematic reviews identified in this overview continues to suggest uncertainty as to the effectiveness of many conservative interventions for the treatment of LET. Although new RCT evidence has been identified with either placebo or active controls, there is uncertainty as to the size of effects reported within them because of the small sample size. Conclusions regarding cost-effectiveness are also unclear. We consider that, although updated or new systematic reviews may also be of value, the primary focus of future work should be on conducting large-scale, good-quality clinical trials using a core set of outcome measures (for defined time points) and appropriate follow-up. Subgroup analysis of existing RCT data may be beneficial to ascertain whether or not certain patient groups are more likely to respond to treatments.Study registrationThis study is registered as PROSPERO CRD42013003593.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…6 There are very few studies in the literature comparing the efficacy of injection of autologous blood with injection of local corticosteroid for lateral epicondylitis. 28,29 There are studies with more than one injection of autologous blood and local corticosteroid in patients who had suboptimal relief of symptoms after the initial injection. 6,14,15,21,22 The optimal interval between autologous blood injections is unknown, but postulated to be six weeks, with up to three injections.…”

Section: Discussionmentioning

confidence: 99%

Comparitive Study of Local Steroid Injection Versus Autologous Blood Injection Therapy for the Management of Lateral Epicondyliti S

Singh¹,

Gawri²,

Singh³

et al. 2015

jemds

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OBJECTIVES:Local corticosteroid infiltration is a common practice of treatment for lateral epicondylitis. In recent studies no statistically significant or clinically relevant results in favour of corticosteroid injections were found. The injection of autologous blood has been reported to be effective for both intermediate and long-term outcomes. It is hypothesized that blood contains growth factors, which induce the healing cascade. METHODS: A total of 50 patients were included in this prospective randomized study. Patients were divided in 2 groups of 25 patients each. Group I received 2 ml local corticosteroid +1 ml 2% lignocaine, Group II received 2 ml autologous blood drawn from ipsilateral upper limb vein +1 ml 2% lignocaine, and at the lateral epicondyle. Outcome was measured using a pain score (VAS). Follow-up was continued for total of six months. RESULTS: The corticosteroid injection group showed a statistically significant decrease in pain compared with autologous blood injection group at six weeks follow up. At final six-month follow-up, autologous blood injection group showed statistically significant decrease in pain compared with corticosteroid injection group. CONCLUSIONS: Autologous blood injection is efficient compared with corticosteroid injection, with less side-effects and minimum recurrence rate in long term.

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Autologous Blood Versus Corticosteroid Local Injection in the Short-Term Treatment of Lateral Elbow Tendinopathy

Abstract: Autologous blood was more effective in short term than the corticosteroid injection.

Cited by 107 publications

References 25 publications

Injection of Autologous Blood versus Corticosteroid for Lateral Epicondylitis: A Randomised Controlled Study

Injection of Autologous Blood versus Corticosteroid for Lateral Epicondylitis: A Randomised Controlled Study

What is the clinical effectiveness and cost-effectiveness of conservative interventions for tendinopathy? An overview of systematic reviews of clinical effectiveness and systematic review of economic evaluations

Comparitive Study of Local Steroid Injection Versus Autologous Blood Injection Therapy for the Management of Lateral Epicondyliti S

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