[논문]Investigation of the efficacy and safety of ultrasound-standardized autologous blood injection as treatment for lateral epicondylitis

Braaksma, Christel; Otte, Jill; Wessel, Ronald N.; Wolterbeek, Nienke

doi:10.5397/cise.2021.00339

[국내논문] Investigation of the efficacy and safety of ultrasound-standardized autologous blood injection as treatment for lateral epicondylitis 원문보기

Clinics in shoulder and elbow, v.25 no.1, 2022년, pp.57 - 64

Braaksma, Christel (Department of Orthopedic Surgery, St. Antonius Hospital) , Otte, Jill (Department of Orthopedic Surgery, St. Antonius Hospital) , Wessel, Ronald N. (Department of Orthopedic Surgery, St. Antonius Hospital) , Wolterbeek, Nienke (Department of Orthopedic Surgery, St. Antonius Hospital)

Abstract ▼ AI-Helper

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

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표/그림 (6)

그림 Fig. 1. Image showing the medical device containing the injection disposable with 12 small needles in blue. The depth of the needles was set to match the ultrasound measured depth. The needles are pushed down with a handle. During perforation, autologous blood is injected into the tendon via the needles. Subsequently, the needles are lifted, and the injection disposable is removed.
그림 Fig. 2. Flowchart of the included patients.
표 Table 2. Primary and secondary outcome measures (n=55)
표 Table 1. Patient demographics
그림 Fig. 3. Changes in patient-rated tennis elbow evaluation (PRTEE) and subjective elbow score (SES) divided into three categories: worse, stable, and improved. A worse PRTEE change score was defined as an increase >12 points, stable as a change score between -11 and 11 points, and improved as a change score 20 points, stable as a change score between -19 and 19 points, and improved as a change score >20 points.
표 Table 3. Results of satisfaction

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