title: Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study.
abstract: OBJECTIVE
  We compared saline, corticosteroid, and autologous blood injections for lateral epicondylitis in a prospective, blinded, randomized, controlled trial. The null hypothesis was that patient-rated outcomes after autologous blood injection would not be superior to corticosteroid and saline injections.
  
  
  METHODS
  Patients with clinically diagnosed lateral epicondylitis of less than 6 months' duration were randomized into 1 of 3 groups to receive a 3-mL injection of saline and lidocaine, corticosteroid and lidocaine, or autologous blood and lidocaine. Of 34 subjects who enrolled, 28 completed follow-up. A total of 10 were randomized to the saline group, 9 to the autologous blood group, and 9 to the steroid group. Every participant had 3 mL blood drawn, and the injection syringe was foil-covered to prevent the subject from knowing the contents. The primary outcome measure was the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Patients completed a pain visual analog scale, DASH, and the Patient-Rated Forearm Evaluation before injection and at 2 weeks, 2 months, and 6 months after injection. We performed statistical analysis using repeated measures of analyses of variance.
  
  
  RESULTS
  There were no significant differences in DASH scores among the 3 groups at 2- and 6-month follow-up points, with the mean scores for saline at 20 and 10, respectively, compared with 28 and 20 for autologous blood and 28 and 13 for steroid injections. Secondary measures showed similar findings, with outcomes scores showing improvement in all 3 groups.
  
  
  CONCLUSIONS
  In this prospective, randomized, controlled trial, autologous blood, corticosteroid, and saline injection provide no advantage over placebo saline injections in the treatment of lateral epicondylitis. Patients within each injection group demonstrated improved outcome scores over a 6-month period.
authors.affiliation: Department of Orthopaedics, University of Colorado-Denver, Denver, CO, USA. jmwolf@uchc.edu
authors.forename: Jennifer Moriatis
authors.initials: JM
authors.lastname: Wolf
authors.forename: Kagan
authors.initials: K
authors.lastname: Ozer
authors.forename: Frank
authors.initials: F
authors.lastname: Scott
authors.forename: Michael J V
authors.initials: MJ
authors.lastname: Gordon
authors.forename: Allison E
authors.initials: AE
authors.lastname: Williams
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000704:Analysis of Variance; D001804:Blood Transfusion, Autologous; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012965:Sodium Chloride / Q000627:therapeutic use*; D013716:Tennis Elbow / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D012965:Sodium Chloride