Comparison of corticosteroid, autologous blood or sclerosant injections for chronic tennis elbow

Branson, Ruben; Naidu, K.; Toit, Carla du; Rotstein, A.; Kiss, Rita M.; McMillan, D.C.; Fooks, L.; Coombes, Brooke K.; Vicenzino, Bill

doi:10.1016/j.jsams.2016.10.010

Cited by 20 publications

(12 citation statements)

References 26 publications

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“…In studies that compared injected blood products such as platelet-rich plasma (PRP) to cortisone injections for tennis elbow, the PRP injections have generally provided superior outcomes to CSI at 6–12 months6. Should a study such as this conclude that blood product injection provides long-term benefit or that cortisone injection leads to long-term harm?…”

Section: Do Cortisone Injections Harm Tendons?mentioning

confidence: 99%

Corticosteroid injections: glass half-full, half-empty or full then empty?

Orchard

2020

Br J Sports Med

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Section: Do Cortisone Injections Harm Tendons?mentioning

confidence: 99%

Corticosteroid injections: glass half-full, half-empty or full then empty?

Orchard

2020

Br J Sports Med

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“…Besides the injectables used in this study, several novel injection therapies are used in recent research such as platelet rich plasma (PRP) and the sclerosing agent polidocanol. [24, 25] These might have a potential benefit in the treatment of LE. Platelet-rich plasma is prepared from autologous whole blood, which is centrifuged to concentrate platelets in plasma.…”

Section: Discussionmentioning

confidence: 99%

“…[26, 27] In the study of Branson there were no differences in effectiveness between autologous blood and polidocanol. [24] Currently there is insufficient evidence that treatment of LE with PRP is more effective than autologous blood. [7, 28] Besides these novel injectables, steroids are still commonly used in the treatment of LE.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of standardized ultrasound guided percutaneous treatment of lateral epicondylitis with application of autologous blood, dextrose or perforation only on pain: a study protocol for a multi-center, blinded, randomized controlled trial with a 1 year follow up

Keijsers

Kuijer

Koenraadt

et al. 2019

BMC Musculoskelet Disord

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Background In the treatment of Lateral Epicondylitis (LE) no single intervention concerning injection therapies has been proven to be the most effective with regard to pain reduction. In this trial 3 injection therapies (perforation with application of autologous blood, perforation with application of dextrose and perforation only) will be compared in a standardized and ultrasound guided way. The objective is to assess the effectiveness of these 3 injection therapies on pain, quality of life and functional recovery. By conducting this study, we hope to make a statement on the effectiveness of injection therapy in the treatment of LE. Hereby, unnecessary treatments can be avoided, a more universal method of treatment can be established and the quality of the treatment can be improved. Methods/design A multicenter, randomized controlled trial with a superiority design and 12 months follow-up will be conducted in four Dutch hospitals. One hundred sixty five patients will be recruited in the age of 18 to 65 years, with chronic symptomatic lateral epicondylitis lasting longer than 6 weeks, which have concordant pain during physical examination. Patients will be randomized by block randomization to one of the three treatment arms. The treatment will be blinded for patients and outcome assessors. The following three injection therapies are compared: perforation with application of autologous blood, perforation with application of dextrose and perforation only. Injections will be performed ultrasound guided in a standardized and automated way. The primary endpoint is: pain (change in ‘Visual Analogue Scale’). Secondary endpoints are quality of life and functional recovery. These measurements are collected at baseline, 8 weeks, 5 months and 1 year after treatment. Discussion When completed, this trial will provide evidence on the effectiveness of injection therapy in the treatment of lateral epicondylitis on pain, quality of life and functional recovery. In current literature proper comparison of the effectiveness of injectables for LE is questionable, due to the lack of standardization of the treatment. This study will overcome bias due to manually performed injection therapy. Trial registration This study is registered in the Trial Register ( www.trialregister.nl ) of the Dutch Cochrane centre. Trial ID; NTR4569. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4569

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“…Many studies have appeared in the last 15–20 years on the efficacy of these stronger agents in soft tissue (including knee ligaments,12–14 elbow ligaments,15–18 shoulder rotator cuff insertions,19 fauces (for snoring and obstructive sleep apnoea)20 21 and dislocating temporomandibular joints (TMJ)) 22. Our clinic gave up on dextrose many years ago, even as a back-up for those with allergies to stronger agents, due to its lack of efficacy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of tetradecyl sulfate versus polidocanol injections for stabilisation of joints that regularly dislocate in an Ehlers-Danlos population

Burling¹

2019

BMJ Open Sport Exerc Med

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ObjectivesTo determine whether there is similarity between tetradecyl sulfate and polidocanol in stabilising a joint from dislocating in patients with Ehlers-Danlos syndrome (EDS).MethodA retrospective analysis of patients with EDS in a sole-practice clinic in New Zealand. Patients must have had the diagnosis of EDS, had easily dislocatable joints, had treatment and at least 3 months’ follow-up. 0.11% tetradecyl sulfate solution, or 0.25% polidocanol solution, was injected to ligament attachments (enthesis) on the side of the joints where they dislocated. Patients were deemed successfully treated if their affected joints were no longer dislocated over a minimum of 3 months’ follow-up (out to 3 years).ResultsOf 250 patients at the time of the study, 46 fitted the criteria. There were 37 treated with tetradecyl sulfate and nine with polidocanol. For the tetradecyl group there were a total of 305 injections around 97 joints: mean 3.1, range 1–22, median 2. For the polidocanol group there were 36 injections around 19 joints: mean 1.9, range 1–8, median 2. The difference of means between group 1 (tetradecyl) and group 2 (polidocanol) is 1.2, CIs 0.34 to 2.98. All patients had no further dislocations of treated joints unless they had a major new injury (two patients).ConclusionThere was no difference between the two groups for stabilising joints from dislocating. These two agents appear promising for treating patients with recurrent joint dislocations in the setting of EDS. Prospective multicentre randomised controlled trials are needed to confirm these data.

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Comparison of corticosteroid, autologous blood or sclerosant injections for chronic tennis elbow

Cited by 20 publications

References 26 publications

Corticosteroid injections: glass half-full, half-empty or full then empty?

Corticosteroid injections: glass half-full, half-empty or full then empty?

Effectiveness of standardized ultrasound guided percutaneous treatment of lateral epicondylitis with application of autologous blood, dextrose or perforation only on pain: a study protocol for a multi-center, blinded, randomized controlled trial with a 1 year follow up

Comparison of tetradecyl sulfate versus polidocanol injections for stabilisation of joints that regularly dislocate in an Ehlers-Danlos population

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