Ultrasound guided autologous blood injection versus Ultrasound therapy in the management of chronic lateral epicondylitis: A randomized controlled trial

Utpalendu Debnath; Rakesh Das

Volume : VIII, Issue : VI, June - 2019

Ultrasound guided autologous blood injection versus Ultrasound therapy in the management of chronic lateral epicondylitis: A randomized controlled trial

Utpalendu Debnath, Rakesh Das

Abstract :

Introduction: Tendinopathy is common in professional athletes as well as in sedentary people. It occurs 30% -50% of all sports related injuries. Injection of autologous blood has been reported beneficial for the treatment of tendinopathy. It is hypothesized that transforming growth factor-β and basic fioblast growth factor carried in the blood will act as humoral mediators to induce the healing cascade. Musculoskeletal ultrasound can document the pathology prior to the injection and accurately identify the site for injection. It also helps in monitoring tendon healing. Materials and methods: This randomized controlled trial was carried out after obtaining permission from Research Ethics Board between September 2016 to August 2018 in the Department of Physical Medicine and Rehabilitation (PMR), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. 40 patients with lateral epicondylitis were included in this study. The independent variable considered were age, sex, occupation, duration and side of affection. The intervention group received autologous blood injection (ABI) whereas the control group received a 5-minute ultrasound application, once a day for 10 days at a frequency of 1 MHz and average intensity of 0.1 W/cm2. Results and Observations: Out of 40 patients recruited, 25 patients were female (62.5%) and 15 were males (37.5%). The intervention group (ABI group) consisted of 12 females and 8 males with a mean age group of 46.55�9.64 years while the control group (Ultrasound group) consisted of 13 females and 7 males with a mean age group of 49.65�8.18 years. There was significant improvement in VAS and PRTEE score in autologous blood injection group compared to Ultrasound group in 6 months follow up. There were also significant improvement in neovascular, echotexture grading and tendon size in ABI group compared to the Ultrasound group in 6 months follow-up. Conclusion: The study showed that single injection of ultrasound guided autologous blood injection is significantly more effective in reducing pain and disability in resistant lateral epicondylitis at 6 months as compared to Ultrasound therapy. This study also confirmed that there was significant improvement of ultrasound parameters in autologous blood injection group compared to Ultrasound group and may be considered as an alternative to surgery in resistant lateral epicondylits.