title: Injection of autologous blood versus corticosteroid for lateral epicondylitis: a randomised controlled study.
abstract: OBJECTIVE
  To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral epicondylitis.
  
  
  METHODS
  21 men and 59 women (mean age, 45.2 years) presenting with lateral epicondylitis were randomised to receive either autologous blood injection (2 ml of autologous venous blood mixed with 1 ml of 2% prilocaine hydrochloride) or corticosteroid injection (1 ml of 40 mg methylprednisolone acetate mixed with 1 ml of 2% prilocaine hydrochloride) given by a single physician. Patients were assessed before (day 0) and after (days 15, 30, and 90) treatment for elbow pain (using a visual analogue scale [VAS]), function (using the patient-rated tennis elbow evaluation [PRTEE] questionnaire), and grip strength (using a hydraulic hand dynamometer). Patients were followed up at 6 months by telephone to assess elbow pain using the VAS.
  
  
  RESULTS
  No complications (infection, skin atrophy, neurovascular damage, or tendon rupture) were noted. 10 patients reported increased pain for up to 2 days after autologous blood injection. In both groups, the VAS score for elbow pain, PRTEE score, and grip strength improved significantly after treatment (p=0.0001), but the pattern of improvement differed. Compared with autologous blood injection, corticosteroid injection improved all 3 scores at a faster rate over the first 15 days (p=0.0001), and then started to decline slightly until day 90. After autologous blood injection, all 3 scores improved steadily and were eventually better (p=0.0001). If a 37% decrease in PRTEE is defined as complete recovery, 38 (95%) of patients with autologous blood injection and 25 (62.5%) of patients with corticosteroid injection achieved complete recovery (p=0.0001).
  
  
  CONCLUSIONS
  Autologous blood injection was more effective over the follow-up period than corticosteroid injection in improving pain, function, and grip strength. It is recommended as a first-line injection treatment because it is simple, cheap, and effective.
authors.affiliation: Orthopaedics and Traumatology Department, Yozgat State Hospital, Turkey.
authors.forename: Hasan Onur
authors.initials: HO
authors.lastname: Arik
authors.affiliation: Orthopaedics and Traumatology Department, Antalya Education and Research Hospital, Turkey.
authors.forename: Ozkan
authors.initials: O
authors.lastname: Kose
authors.affiliation: Orthopaedics and Traumatology Department, Antalya Education and Research Hospital, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Guler
authors.affiliation: Orthopaedics and Traumatology Department, Batman Medical Park Hospital, Turkey.
authors.forename: Gokmen
authors.initials: G
authors.lastname: Deniz
authors.affiliation: Orthopaedics and Traumatology Department, Antalya Education and Research Hospital, Turkey.
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Egerci
authors.affiliation: Physical Medicine and Rehabilitation, Medical Faculty, Bozok University, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ucar
mesh_terms: D000328:Adult; D001804:Blood Transfusion, Autologous; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077555:Methylprednisolone Acetate; D008875:Middle Aged; D013716:Tennis Elbow / Q000628:therapy*
chemical_list: D005938:Glucocorticoids; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone
keywords: blood; steroids; tennis elbow