Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

Table 1

The literature regarding published outcomes of autologous blood injection for lateral epicondylitis. Units are as authors have provided, in means, confidence intervals (CI) or percentages.

Study and design	Participants	Intervention/comparison	Outcome measures	Result
Thanasas et al. [8]; RCT	𝑁=28, symptom duration equal to or more than 3 months, no previous local injection treatment	𝑁=14 treated with autologous blood injection under ultrasound guidance; 𝑁=14 treated with platelet rich plasma under ultrasound guidance; Postinjection eccentric strengthening followed by all	Pain visual analogue score, 6/12; Liverpool elbow score, 6/12	No significant difference between groups by Liverpool elbow score; Mean visual analogue score improvement; Platelet rich group; 3.8 points (95% confidence interval (CI), 3.1–4.5); Autologous blood injection group; 2.5 points (95% CI, 1.9–3.1)
Wolf et al. [9]; RCT	𝑁=34 patients, 28 followed up; <6/12 history of lateral epicondylitis	Injection of saline and lidocaine, or corticosteroid and lidocaine, or; autologous blood and lidocaine; rehabilitation regime not provided	Pain visual analogue score, Disabilities of the arm, shoulder and hand questionnaire and patient-rated Forearm Evaluation to 6/12	Patients in each injection group had significantly improved outcome scores at 6/12; Autologous blood or corticosteroid provided no advantage over placebo saline.
Creaney et al. [10]; RCT	𝑁=150, patients who had physiotherapy treatment without improvement; 130 followed up	Platelet rich plasma injection (𝑁=80); Autologous blood injection (𝑁=70); rehabilitation regime not provided	patient rated tennis elbow Evaluation to 6/12, need for surgery	43/60 autologous blood injection patients had at least 25/100 points improvement on the patient rated tennis elbow evaluation; 12 autologous blood injection patients had surgery
Ozturan et al. 2010 [11]; RCT	𝑁=60 patients; ≥6/12 symptoms; 𝑁=20 in each treatment group	One-two cortisone injections or; one-two autologous blood injections; or; three extracorporeal shock wave treatments; rehabilitation regime not provided	Thomsen test, grip strength and ? self-designed functional scale at one year	At 4 weeks cortisone provided best result but at one year 50% relapse; Best results at one year for extracorporeal shock wave and then autologous blood injection
Bharti et al. 2010 [1]; case series	𝑁=25≤1/12 symptom duration	One autologous blood injection rehabilitation regime not provided	Pain visual analogue score; Verhaar scoring system of pain, satisfaction; subjective grip and Thomsen test of pain on resisted wrist extension to 12/52	One poor and one fair result, 23 good/excellent
Kazemi et al. 2010 [2]; RCT	𝑁=60 patients; 𝑁=30 in each treatment group; First sign of symptoms	One-two cortisone injections or; one-two autologous blood injections.; Patients told to return to activity gradually	Disabilities of the arm, shoulder, and hand questionnaire Nirschl Score; Pain visual analogue score; Grip; Pain Algometer to 8/52	Significant improvements after both interventions, better results for autologous blood injection
Edwards and Calandruccio [6]; case series	𝑁=28 who had no previous treatment for lateral epicondylitis; uncertain duration of symptoms	One-three autologous blood injections; 3/52 rest in wrist splint; Return to normal activity at 6/52	Nirschl score; Pain visual analogue score for 6/12 to 2 years	22/28 complete pain relief; Significant improvement in all patients
Dehghani et al. [12]; case series; (abstract)	𝑁=22 who previously failed conservative treatment; uncertain duration of symptoms	One autologous blood injections; rehabilitation regime not provided	Pain visual analogue score 100 point scale; patient rated tennis elbow Evaluation; uncertain duration of followup	Average pain scores went from 44–9 points; Average patient rated tennis elbow evaluation scores went from 42 to 10 points
Ul Gani et al. [13]; case series	N = 26; 3/12 to 2 years symptomatic; Excluded if did not attend followup	One-two autologous blood injections; Sling for 1/52; Light duties for 3/52; Wrist extensor stretches at 4/52	Nirschl score; Pain visual analogue score for a mean of 8/12	Mean Nirschl score went from 3.3 to 1.2; Mean Pain score went from 5.5 to 3/10; 10/26 satisfied; 11/26 not satisfied; 2nd injection of no greater benefit
Saldana [14]; RCT; Conference abstract	𝑁=75 with Pain visual analogue score >5/10; 36 assigned to steroid injection; 39 assigned to autologous blood	One Steroid injection = 9; Two Steroid injections = 14; Three Steroid injections = 3; OR; One autologous blood and analgesic = 30; Two autologous blood and analgesic = 9; All patients advised to use nonsteroidal anti-inflammatories, grasp with forearm in supination, stretch, use splints	Pain visual analogue score; uncertain duration of followup	10 healed with one injection of blood; 12 healed with three injections of steroid
Connell et al. [15]; case series	𝑁=35; symptoms for 6/12 to 4 years	Dry needling and autologous blood with ultrasound guidance 26 patients had two injections, three patients had three injections	Nirschl score; Pain visual analogue score to 6/12	Significant improvement in all patients except two who had surgery
Wang et al. [16]	Unable to retrieve full paper