USG-guided injection of corticosteroid for lateral epicondylitis does not improve clinical outcomes: a prospective randomised study

• Published in: Archives of orthopaedic and trauma surgery Vol. 137; no. 5; pp. 601 - 606
• Main Authors: Gulabi, Deniz, Uysal, Mehmet Ali, Akça, Ahmet, Colak, Ilker, Çeçen, Gultekin Sıtkı, Gumustas, Seyitali
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2017; Springer Nature B.V
• Subjects: Adult; Elbow; Elbow - diagnostic imaging; Female; Glucocorticoids - administration & dosage; Humans; Injections - methods; Male; Medicine; Medicine & Public Health; Methylprednisolone - administration & dosage; Middle Aged; Orthopaedic Surgery; Orthopedics; Tennis Elbow - drug therapy; Treatment Outcome; Ultrasonography - methods; Ultrasound-guided; Lateral epicondylitis; Corticosteroid injection
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-017-2657-3

Background Corticosteroid injection used to be the treatment of choice for lateral epicondylitis. Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinical study was to compare the clinical therapeutic effects of blinded and USG-guided corticosteroid injection therapy in lateral epicondylitis. Patients and methods Forty patients with chronic lateral epicondylitis were included in this clinical trial. The patients were randomly allocated to blinded group or USG-guided injection group according to a computer-generated randomisation list. All blinded injections were administered by an orthopaedic surgeon and all ultrasound-guided injections were made by a radiologist experienced in this technique. All patients were injected under aseptic conditions using 40 mg/2 mL methylprednisolone acetate. The outcomes of both treatments were assessed by an independent assessor at pre-injection, then at 6-week and 3- and 6-month follow-up assessments. The assessor evaluated the q-DASH, VAS, and grip strength scores. Results No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6 weeks and 3 and 6 months post-injection. No statistically significant difference was determined between the groups in respect of the VAS scores preoperatively and at 6 weeks and 6 months. No systemic or local complications were reported during the treatment. Conclusion There was no statistically significant difference compared to the blinded injection technique, and the mean score differences between the groups are of no clinical relevance.