Long-term follow-up of platelet-rich plasma injections for refractory lateral epicondylitis

Brkljac, Milos; Conville, James; Sonar, Ulhas; Kumar, Shyam

doi:10.1016/j.jor.2019.08.023

Cited by 13 publications

(12 citation statements)

References 34 publications

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“…The sustained improvement in VAS scores shows that the procedure is an effective long-term treatment for lateral elbow tendinopathy. 7 Compared with the literature, the characteristics of our patients were similar to those of other published studies, 6,30 and our patients had similar or lower postoperative pain, with a longer-term follow-up. 25,28,29…”

Section: Discussionsupporting

confidence: 88%

“…25,28,29 The follow-up of 90 months is longer than that of most long-term studies on lateral epicondylitis. 1,6,7,25,29,34,35 Patient satisfaction with the procedure continued to be 100%, and there was no recurrence of lateral elbow tendinopathy. According to the literature, recurrence after minimally invasive procedures can be as low as 0% (0/36) 34 for a short-term follow-up of 1 year and can be as high as 26% (8/31) 7 for longer follow-up of 5.2 years.…”

Section: Discussionmentioning

confidence: 93%

“…1,6,7,25,29,34,35 Patient satisfaction with the procedure continued to be 100%, and there was no recurrence of lateral elbow tendinopathy. According to the literature, recurrence after minimally invasive procedures can be as low as 0% (0/36) 34 for a short-term follow-up of 1 year and can be as high as 26% (8/31) 7 for longer follow-up of 5.2 years. Open surgery has been shown to have lower recurrence rates, ranging from 0% (0/70 at 5 years) 16 to 5% (2/40 at 2 years).…”

Section: Discussionmentioning

confidence: 93%

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Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

et al. 2021

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Background: In a study from our institution, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon for recalcitrant lateral elbow tendinopathy showed excellent safety profiles, high tolerability, efficiency, sustained pain relief, functional improvement, and sonographic evidence of tissue healing in 20 patients at 3 years’ follow-up. Purpose: To explore the long-term clinical and sonographic results of ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon. Study Design: Case series; Level of evidence, 4. Methods: The same cohort of 20 patients was recalled after 7 years, and visual analog scale (VAS) for pain and Disabilities of the Arm, Shoulder and Hand (DASH) scores, need for secondary intervention, and overall satisfaction were assessed. They were also reassessed using ultrasound imaging of the brevis and the common extensor tendon to evaluate tendon hypervascularity, tendon thickness, and the progress or the recurrence of the hypoechoic scar tissue. Results: We successfully scored 19 patients and performed ultrasound on 16 patients with a median follow-up of 90 months (range, 86-102 months). There were no adverse outcomes and satisfaction remained at 100% (6 patients, satisfied; 13 patients, very satisfied). No patient developed a recurrence of symptoms and signs of lateral elbow tendinopathy, and therefore no secondary intervention was required. The improvement from baseline and early term scores was sustained ( P < .001 for all). At 90 months, there was a significant improvement in VAS scores and DASH–Compulsory scores compared with preprocedure scores and all follow-up times until 3 months. There was no difference in VAS scores and DASH–Compulsory scores at 90 months compared with 6 and 36 months. For DASH–Work scores, there was a significant improvement at 90 months compared with preprocedure scores, but there was no difference between DASH–Work scores at 90 months and scores at all other points of follow-up. At 90 months, hypervascularity remained resolved in 79% of patients, while all patients had reduced tendon swelling and sustained resolution or reduction of the hypoechoic lesion. Conclusion: At the long-term follow-up of 90 months, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon, previously shown to enhance recovery of lateral elbow tendinopathy, demonstrated good durability of pain relief and functional recovery that was previously achieved. This was accompanied by sustained sonographic tissue healing with no significant deterioration.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

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Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

et al. 2021

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“…In this systematic review, Hardy et al 17 conclude from their investigation that PRP injections are an appropriate alternative for the treatment of lateral epicondylitis. Indeed, PRP injections have shown efficacy in some previous studies, 3,6,7 but not all studies have made similar determinations. [14][15][16]20 Likewise, previously published systematic reviews and meta-analyses comparing PRP use with other interventions for the treatment of lateral epicondylitis have reached variable conclusions.…”

Section: See Related Article On Page 3360mentioning

confidence: 92%

“…[3][4][5] More recently, the role of plateletrich plasma (PRP) injections in the management of lateral epicondylitis has been examined. Both PRP 3,6,7 and autologous blood 8 injections have been introduced and recommended by some investigators as effective alternative treatments. PRP is known to improve osteochondral healing both macroscopically and microscopically in animal models.…”

Section: See Related Article On Page 3360mentioning

confidence: 99%

Editorial Commentary: Elbow Lateral Epicondylitis Treatment Using Platelet-Rich Plasma

Field

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The effect of leucocyte concentration of platelet-rich plasma on outcomes in patients with lateral epicondylitis: a systematic review and meta-analysis

Shim

Lee

Park

et al. 2022

Journal of Shoulder and Elbow Surgery

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Long-term follow-up of platelet-rich plasma injections for refractory lateral epicondylitis

Cited by 13 publications

References 34 publications

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

Editorial Commentary: Elbow Lateral Epicondylitis Treatment Using Platelet-Rich Plasma

The effect of leucocyte concentration of platelet-rich plasma on outcomes in patients with lateral epicondylitis: a systematic review and meta-analysis

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