Prospective Evaluation of Periarticular Hyaluronic Acid Infiltration for the Treatment of Lateral Epicondylitis

Abstract

Objective: To prospectively, clinically and functionally follow-up patients previously diagnosed with lateral epicondylitis after periarticular application of hyaluronic acid and analyze the results. Methods: All patients were previously treated conservatively and had no clinical improvement. Data such as age, positivity for specific tests (Cozen and Mill), visual analogue pain scale (VAS) before and during dorsiflexion of the wrist with resistance, diagnosis time, Mayo Elbow Performance Score was collected. Patients were reevaluated 30 and 90 days after application. Results: The positivity rates for Cozen and Mill tests were identical, starting at 100%, dropping to 50% after one month, and ending at 41.7% after 3 months. The initial Mayo Elbow Score average was 61.3 points; 85.8 in the first month, remaining at 85 in the third month. VAS in active force situations had the initial average of 8.1; after one month it dropped to 3.8, and 3.6 after three months. At rest, the initial average was 5.9; after one month it decreased to 3 and ended at 2.1 in three months. Conclusion: Patients showed improvement in pain parameters, in the Mayo Elbow Performance Score standard, but with 25% of failure in satisfaction. Level of evidence IV, Case series.

Comparison of Hyaluronate & Steroid Injection in the Treatment of Chronic Lateral Epicondylitis and Evaluation of Treatment Efficacy With MRI: A Single-Blind, Prospective, Randomized Controlled Clinical Study

“…However, VAS for pain decreases in this study were smaller than the minimum clinically important improvement [21]. Contrarily, another study showed a high rate of failure in treatment (25%) when periarticular hyaluronic infiltration was used for resistant cases of lateral epicondylitis [22].…”

Efficacy of low molecular weight hyaluronic acid (500–730 kDa) in post-traumatic pathology of periarticular soft tissues at different sites: data from an open-label pilot clinical study

“…Stirma и соавт. [16], изучавших действие этого препарата при ЛЭ (n=52): средняя интенсивность боли при движении после курса ЛИТ ГлК снизилась с 8,1 до 3,6 см по ВАШ.…”

The Role of Hyaluronic Acid in Intervertebral Disc Regeneration

“…HA, which was first isolated in the 1930s, is a distinctive glycosaminoglycan, which, unlike other glycosaminoglycans such as heparan sulphate, chondroitin sulphate, and keratan sulphate, is non-sulphated [52]. It is widely used in treating osteoarthritis [36,[53][54][55][56][57][58] and in tissue-engineering approaches for disc repair [59,60]. HA ( Figure 3) is an abundant polymer of the ECM with a molecular weight of approximately 10 6 -10 7 Da in vivo [61].…”