Gregor Stenhouse1, Paul Sookur, Martin Watson. 1. West Middlesex University Hospital NHS Trust, Twickenham Road, Isleworth, Middlesex, TW76AF, UK, gregors45@gmail.com.
Abstract
OBJECTIVE: To evaluate whether autologous conditioned plasma offers any therapeutic advantage over ultrasound-guided dry needling as a stand-alone procedure in the treatment of refractory lateral epicondylitis. MATERIALS AND METHODS: Prospective, randomized pilot study of 28 patients (11 men, 17 women, mean age, 49.1 years) with refractory lateral epicondylitis (mean symptom duration, 19.1 months) who underwent either dry needling (n = 13) ordry needling combined with autologous conditioned plasma (ACP) injection (n = 15). Each patient received two separate injections (0 weeks and 1 month) and analysis of visual analogue pain scores (VAS) and Nirschl scores were performed pre-procedure, at 2 months and final evaluation at 6 months. Successful treatment was defined as more than a 25 % reduction in pain scores without re-intervention. Data was analyzed using the Mann-Whitney test and local research ethics committee approval was obtained. RESULTS: At 2 months, the mean VAS improvement was 0.85 (12.3 %) in the dry needling group compared to 2.19 (27.1 %) in the ACP group (p = 0.76) and there was a 5.83-point and 20.3-point Nirschl score improvement respectively (p = 0.72). At the final follow-up of 6 months, the mean VAS improvement was 2.37 (34 %) in the dry needling group compared to 3.92 (48.5 %) in the ACP group (p = 0.74) and there was a 22.5-point and 40-point Nirschl score improvement, respectively (p = 0.82). CONCLUSIONS: There is a trend to greater clinical improvement in the short term for patients treated with additional ACP, however no significant difference between the two treatment groups was demonstrated at each follow-up interval. A larger, multicenter, randomized controlled trial is required to corroborate the results of this pilot study.
RCT Entities:
OBJECTIVE: To evaluate whether autologous conditioned plasma offers any therapeutic advantage over ultrasound-guided dry needling as a stand-alone procedure in the treatment of refractory lateral epicondylitis. MATERIALS AND METHODS: Prospective, randomized pilot study of 28 patients (11 men, 17 women, mean age, 49.1 years) with refractory lateral epicondylitis (mean symptom duration, 19.1 months) who underwent either dry needling (n = 13) or dry needling combined with autologous conditioned plasma (ACP) injection (n = 15). Each patient received two separate injections (0 weeks and 1 month) and analysis of visual analogue pain scores (VAS) and Nirschl scores were performed pre-procedure, at 2 months and final evaluation at 6 months. Successful treatment was defined as more than a 25 % reduction in pain scores without re-intervention. Data was analyzed using the Mann-Whitney test and local research ethics committee approval was obtained. RESULTS: At 2 months, the mean VAS improvement was 0.85 (12.3 %) in the dry needling group compared to 2.19 (27.1 %) in the ACP group (p = 0.76) and there was a 5.83-point and 20.3-point Nirschl score improvement respectively (p = 0.72). At the final follow-up of 6 months, the mean VAS improvement was 2.37 (34 %) in the dry needling group compared to 3.92 (48.5 %) in the ACP group (p = 0.74) and there was a 22.5-point and 40-point Nirschl score improvement, respectively (p = 0.82). CONCLUSIONS: There is a trend to greater clinical improvement in the short term for patients treated with additional ACP, however no significant difference between the two treatment groups was demonstrated at each follow-up interval. A larger, multicenter, randomized controlled trial is required to corroborate the results of this pilot study.
Authors: Steven L J James; Kaline Ali; Chris Pocock; Claire Robertson; Joy Walter; Jonathan Bell; David Connell Journal: Br J Sports Med Date: 2007-03-26 Impact factor: 13.800
Authors: Salma Chaudhury; Mauricio de La Lama; Ronald S Adler; Lawrence V Gulotta; Brendan Skonieczki; Anthony Chang; Peter Moley; Frank Cordasco; Jo Hannafin; Stephen Fealy Journal: Skeletal Radiol Date: 2012-09-22 Impact factor: 2.199
Authors: David A Connell; Kaline E Ali; Muaaze Ahmad; Simon Lambert; Steven Corbett; Mark Curtis Journal: Skeletal Radiol Date: 2006-03-22 Impact factor: 2.199
Authors: Luca Maria Sconfienza; Miraude Adriaensen; Domenico Albano; Maria Pilar Aparisi Gómez; Alberto Bazzocchi; Ian Beggs; Bianca Bignotti; Vito Chianca; Angelo Corazza; Danoob Dalili; Miriam De Dea; Jose Luis Del Cura; Francesco Di Pietto; Eleni Drakonaki; Fernando Facal de Castro; Dimitrios Filippiadis; Jan Gielen; Salvatore Gitto; Harun Gupta; Andrea S Klauser; Radhesh Lalam; Silvia Martin; Carlo Martinoli; Giovanni Mauri; Catherine McCarthy; Eugene McNally; Kalliopi Melaki; Carmelo Messina; Rebeca Mirón Mombiela; Benedikt Neubauer; Marina Obradov; Cyprian Olchowy; Davide Orlandi; Athena Plagou; Raquel Prada Gonzalez; Saulius Rutkauskas; Ziga Snoj; Alberto Stefano Tagliafico; Alexander Talaska; Violeta Vasilevska-Nikodinovska; Jelena Vucetic; David Wilson; Federico Zaottini; Marcello Zappia; Georgina Allen Journal: Eur Radiol Date: 2019-12-16 Impact factor: 5.315
Authors: Radosław Lebiedziński; Marek Synder; Piotr Buchcic; Michał Polguj; Andrzej Grzegorzewski; Marcin Sibiński Journal: Int Orthop Date: 2015-07-30 Impact factor: 3.075