Comparison of corticosteroid, autologous blood or sclerosant injections for chronic tennis elbow
Abstract Objectives To compare three different ultrasound-guided injections for chronic tennis elbow Design Assessor-blinded, randomized controlled comparative trial Methods 44 patients with clinically diagnosed tennis elbow, confirmed by Doppler ultrasound, received under ultrasound guidance, a sin...
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Published in | Journal of science and medicine in sport Vol. 20; no. 6; pp. 528 - 533 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Australia
Elsevier Ltd
01.06.2017
Elsevier Limited |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract Objectives To compare three different ultrasound-guided injections for chronic tennis elbow Design Assessor-blinded, randomized controlled comparative trial Methods 44 patients with clinically diagnosed tennis elbow, confirmed by Doppler ultrasound, received under ultrasound guidance, a single corticosteroid injection (n = 14), or two injections (separated by 4weeks) of either autologous blood (n = 14) or polidocanol (n = 16). Clinical and ultrasound examination was performed at baseline, 4,12 and 26weeks. Results Complete recovery or much improvement was greater for corticosteroid injection than autologous blood and polidocanol at 4weeks (p < 0.001, number needed to treat 1 (95% CI 1 to 2). In contrast, at 26weeks corticosteroid was significantly worse than polidocanol (p = 0.004, number needed to harm 2 (1 to 6). Recurrence after corticosteroid injection was significantly higher than autologous blood or polidocanol (p = 0.007, number needed to harm 2 (1 to 4). Corticosteroid injection produced greater reduction in tendon thickness and vascularity than autologous blood at 4weeks only. Compared to autologous blood, polidocanol reduced tendon thickness at 4 and 12weeks and reduced echogenicity and hyperaemia after 12 or 26weeks respectively. Conclusions Injections of corticosteroid cannot be recommended over polidocanol or autologous blood, because despite beneficial short-term effect there were inferior long-term effects. Whether polidocanol or autologous blood injections are effective is unknown, especially as their global effect profiles are not unlike previously reported for wait-and-see. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 1440-2440 1878-1861 |
DOI: | 10.1016/j.jsams.2016.10.010 |