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Ozturan KE, Yucel I, Cakici H, Guven M, Sungur I. Autologous Blood and Corticosteroid Injection and Extracoporeal Shock Wave Therapy in the Treatment of Lateral Epicondylitis. ORTHOPEDICS 2010; 33:84
Dr. Reeves' Notes: This was a randomized control trial. 5 insertions of the needle were made so there was needle trauma in the steroid and the autologous blood group. If the blood group were not 50% better at 1 month they were given a 2nd treatment. The long term results favored the non steroid groups in functional testing measures. Given the spontaneous remission in tennis elbow in many in 6-24 months, this outcome, despite a non injection group control suggests that autologous blood which is low cost, may be the most cost effective treatment approach to treatment of lateral epicondylosis. More peppering may be helpful but has a downside of more trauma potential to small radial nerve branches.
The complete study on Blood vs Steroid vs Shock Wave Therapy is available in PDF format here.
A copy of the abstract on Blood vs Steroid vs Shock Wave Therapy is available here, with a copy of the content below.
Lateral epicondylitis is a common disorder characterized by pain and tenderness over the lateral epicondyle. It occurs most frequently as a result of minor, unrecognized trauma during sports activities and occupation-related physical activities. The goal of this study was to evaluate the short-, medium-, and long-term effects of corticosteroid injection, autologous blood injection, and extracorporeal shock wave therapy in the treatment of lateral epicondylitis. Sixty patients (32 women, 28 men) with lateral epicondylitis were randomly divided into 3 groups: group 1 received a corticosteroid injection; group 2, an autologous blood injection, and group 3, extracorporeal shock wave therapy. Thomsen provocative testing, upper extremity functional scores, and maximal grip strength were used for evaluation. Outcomes were assessed at 4, 12, 26, and 52 weeks. Corticosteroid injection gave significantly better results for all outcome measures at 4 weeks; success rates in the 3 groups were 90%, 16.6%, and 42.1%, respectively. Autologous blood injection and extracorporeal shock wave therapy gave significantly better Thomsen provocative test results and upper extremity functional scores at 52 weeks; the success rate of corticosteroid injection was 50%, which was significantly lower than the success rates for autologous blood injection (83.3%) and extracorporeal shock wave therapy (89.9%). Corticosteroid injection provided a high success rate in the short term. However, autologous blood injection and extracorporeal shock wave therapy gave better long-term results,especially considering the high recurrence rate with corticosteroid injection. We suggest that the treatment of choice for lateral epicondylitis be autologous blood injection.