Abstract :
Background: Lateral epicondylitis often known as tennis elbow is a common cause for pain in the lateral side of the elbow. It has been shown that a local injection of autologous blood in a case of lateral epicondylitis provides cellular and humoral factors to the site of lesion and triggers a healing cascade. The aim of this study was to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow.
Materials & Methods: A single blinded prospective randomized study was performed. Total of 40 patients were deputed sequentially into two groups of 20 patients each, A (Autologous Blood Injection) and B(Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Patients were evaluated before injection and on subsequent consultations at 4 weeks, 12 weeks & 6 months.
Results: Before the injection, the mean VAS scores and Nirschl stages were similar in group A and group B, in group A mean VAS score 7.37 in group B 7.47 with an insignificant P value of 0.74, mean Nirschl stage in group A and group B was 5.84 and 6.05 respectively with P value of 0.45.Group B had better pain relief at 4 weeks post procedure in comparison to group A.
After 4 weeks, VAS score and Nirschl stage started decreasing in group A, but to the contrary in group B average VAS pain score raised from 1.68 to 1.88 and Nirschl stage too increased from 1.50 to 1.84 at 12 weeks & 6 months of follow up of patients respectively.
At the six-month follow-up 90% patients had complete pain relief in group A in comparison to only 45% in group B; Seven out of 20 (35%) patients had recurrence of pain at 6 months of follow up in group B but none of the patients reported recurrence of pain or disability in group A.
Conclusion: Injection of autologous blood is an efficient treatment modality for lateral epicondylitis, which is simple, cheap, with less side-effect and minimum recurrence rate.
Keyword :
Lateral epicondylitis, Tennis elbow, Local corticosteroid, Autologous blood injection, RCT