Treatment of lateral epicondilitis using three different local injection modalities: A randomized prospective clinical trial


DOĞRAMACI Y., KALACI A., SAVAŞ N., DUMAN İ. G., Yanat A. N.

Archives of Orthopaedic and Trauma Surgery, cilt.129, sa.10, ss.1409-1414, 2009 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 129 Sayı: 10
  • Basım Tarihi: 2009
  • Doi Numarası: 10.1007/s00402-009-0832-x
  • Dergi Adı: Archives of Orthopaedic and Trauma Surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1409-1414
  • Anahtar Kelimeler: Lateral epicondilitis, Local injection treatment, Peppering injection technique, Steroid
  • Hatay Mustafa Kemal Üniversitesi Adresli: Evet

Özet

Background: To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis. Methods: In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition. Results: There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002). Conclusion: In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results. © Springer-Verlag 2009.