Advances in Orthopedics / 2012 / Article / Tab 1

Clinical Study

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 designParticipantsIntervention/comparisonOutcome measuresResult

Thanasas et al. [8]
RCT
, symptom duration equal to or more than 3 months, no previous local injection treatment treated with autologous blood injection under ultrasound guidance
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
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
, patients who had physiotherapy treatment without improvement
130 followed up
Platelet rich plasma injection ( )
Autologous blood injection ( )
rehabilitation regime not provided
patient rated tennis elbow Evaluation to 6/12, need for surgery43/60 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
patients
≥6/12 symptoms
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
≤1/12 symptom durationOne 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
patients
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
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)
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
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
  
symptoms for 6/12 to 4 years
Dry needling and autologous blood with ultrasound guidance 26 patients had two injections, three patients had three injectionsNirschl 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

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