A randomised control trial to evaluate the efficacy of autologous blood injection versus local corticosteroid injection for treatment of lateral epicondylitis

Abstract

ObjectivesLocal corticosteroid infiltration is a common practice of treatment for lateral epicondylitis. In recent studies no statistically significant or clinically relevant results in favour of corticosteroid injections were found. The injection of autologous blood has been reported to be effective for both intermediate and long-term outcomes. It is hypothesised that blood contains growth factors, which induce the healing cascade.MethodsA total of 60 patients were included in this prospective randomised study: 30 patients received 2 ml autologous blood drawn from contralateral upper limb vein + 1 ml 0.5% bupivacaine, and 30 patients received 2 ml local corticosteroid + 1 ml 0.5% bupivacaine at the lateral epicondyle. Outcome was measured using a pain score and Nirschl staging of lateral epicondylitis. Follow-up was continued for total of six months, with assessment at one week, four weeks, 12 weeks and six months.ResultsThe corticosteroid injection group showed a statistically significant decrease in pain compared with autologous blood injection group in both visual analogue scale (VAS) and Nirschl stage at one week (both p < 0.001) and at four weeks (p = 0.002 and p = 0.018, respectively). At the 12-week and six-month follow-up, autologous blood injection group showed statistically significant decrease in pain compared with corticosteroid injection group (12 weeks: VAS p = 0.013 and Nirschl stage p = 0.018; six months: VAS p = 0.006 and Nirschl p = 0.006). At the six-month final follow-up, a total of 14 patients (47%) in the corticosteroid injection group and 27 patients (90%) in autologous blood injection group were completely relieved of pain.ConclusionsAutologous blood injection is efficient compared with corticosteroid injection, with less side-effects and minimum recurrence rate.

A Comparative Study on the Efficacy of Local Infiltration of Autologous Blood versus Local Corticosteroid Infiltration for the Treatment of Chronic Lateral Epicondylitis Elbow

“…This was seen similar in two separate studies which observed mean age of 45 and 43 years 11 . Another study observed the mean age to be 46.5 years 6 .…”

“…A prospective, double-blinded, randomised trial by Creaney et al 11 published in British Journal of Sports Medicine 2011 compared the effectiveness of PRP versus autologous blood. The main outcome measure was PRTEE.…”

A comparative effectiveness of activated platelet-rich plasma versus autologous whole blood in the management of lateral epicondylitis: A randomized clinical trial of functional outcome

“…The differences in sample size, 28 patients in Thanasas and 150 patients in Creaney may be a potential reason for differences between these two studies. Study of Dojode (2012) [21] also showed that in autologous injection group, more number of patients suffered from post intervention pain as compared to corticosteroid injection group. Another study conducted by Ozturan et al (2010) [22] found that 89% of patients had no more pain after 2 days and rest 11% of patients had pain from 4 to 6 days.…”

Efficacy of Local Infiltration of Autologous Blood Versus Local Corticosteroid Injection- The Treatment of Chronic Tennis Elbow

“…This was seen similar in two separate studies, which observed mean age of 45 and 43 years. 8 Another study observed the mean age to be 46.5 years. 6 In this current study, out of the 50 participants, 29 were male patients and 21 were female patients.…”