Autologous Blood Injection In The Treatment Of Lateral Epicondylitis

Abstract

Objective: To know the results of autologous blood injection in lateral epicondylitis. Out Patient
Department of Peshawar Institute of Medical Sciences, Peshawar from March 2013 to Dec. 2013.
Material and Methods: It is a prospective descriptive study conducted on 66 patients with
lateral epicondylitis, fulfilling the inclusion criteria. DASH (Disability of the Arm, Shoulder and
Hand) score was used as primary outcome measure and Thomsen provocative test to elicit pain
and Nirschl score to evaluate pain on function as secondary outcome were used before
autologous blood injection and at 12 and 24 weeks after injection of autologous blood. VAS score
was used to measure pain. 2ml of autologous venous blood mixed with 1 ml of lignocaine 2%
solution and injected by introducing the needle into lateral epicondyle of humerous at site which is
most tender by peppering technique. Patients were followed up at 2 weeks, 6 weeks, 12 weeks
and 24 weeks interval. Patient DASH score, VAS pain score and Nirschl score was recorded
before autologous injection and at 12 & 24 weeks post injection. P-value of < 0.05 deemed to
indicate statistical significance and was calculated where applicable.
Results: Out of 83 patients 66 met the inclusion criteria. Mean age of the patients was 39.68
years +12.77. 32 of these patients were females and 34 were males. Dominant elbow was
involved in 42 patients. Mean duration of symptoms was 8.9+3.2 months. During follow up 10
patients were lost (6 females and 4 males). DASH score of patients improved from 86 to 64 at 12
weeks and to 49 at 24 weeks (P value <0.0001). Mean VAS improved from 7.63 to 3.89 and 1.77
respectively at 12 and 24 week follow up (P value <0.0001). Nirschl score of the patients
receiving autologous blood injection improved to 3.69 and 1.66 at 12 and 24 weeks follow up
respectively from 5.98 score of pre-autologous blood injection (Pvalue <0.0001).
Conclusion: Autologous blood injection has shown improvement in pain and physical activity
and provide acceptable short to long term results.