Medial epicondylitis: is ultrasound guided autologous blood injection an effective treatment?

Abstract

OBJECTIVE:

To assess if ultrasound guided autologous blood injection is an effective treatment for medial epicondylitis.

METHODS:

Twenty patients (13 men, 7 women) with refractory medial epicondylitis with symptom duration of 12 months underwent sonographic evaluation. Tendinosis was confirmed according to three sonographic criteria: echo texture, interstitial tears and neovascularity. The tendon was then dry needled and autologous blood was injected. Patients were reviewed at 4 weeks and at 10 months. VAS scores and modified Nirschl scores were assessed pre-procedure and post-procedure.

RESULTS:

There was significant reduction in VAS pain score between pre-procedure and 10 months post-procedure when it had a median (IQR) of 1.00 (1-1.75), range 0-7. The median (IQR) Nirschl score, which at pre-procedure was 6.00 (5-7), range 4-7, had decreased at 4 weeks to 4.00 (2.25-5), range 2-7, and at 10 months to 1.00 (1-1.75), range 0-7, revealing a significant decrease (z = 3.763, p<0.001). The hypo-echoic change in the flexor tendon significantly decreased between pre-procedure, when there was a mean (SD) of 6.45 (1.47), and at 10 months, when it was 3.85 (2.37) (p<0.001). Doppler ultrasound showed that neovascularity decreased between pre-procedure, when there was a mean (SD) of 6.10 (1.62), range 4-9, and at 10 months, when it was 3.60 (2.56), range 0-9 (p<0.001).

DISCUSSION:

The combined action of dry needling and autologous blood injection under ultrasound guidance appears to be an effective treatment for refractory medial epicondylitis as demonstrated by a significant decrease in VAS pain and a fall in the modified Nirschl scores.

• Authors: S P Suresh, K E Ali, H Jones, D A Connell
• Journal: British journal of sports medicine (Br J Sports Med) Vol. 40 Issue 11 Pg. 935-9; discussion 939 (Nov 2006) ISSN: 1473-0480 [Electronic] England
• PMID: 16990441 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Blood Transfusion, Autologous (methods)
• Female
• Humans
• Male
• Middle Aged
• Pain Measurement
• Tennis Elbow (diagnostic imaging, therapy)
• Treatment Outcome
• Ultrasonography, Interventional