Dogramaci Yunus, Kalaci Aydiner, Savaş Nazan, Duman I Gokhan, Yanat A Nedim
Department of Orthopaedics and Traumatology, Medical Faculty, Mustafa Kemal University, 31100 Antakya, Hatay, Turkey.
Arch Orthop Trauma Surg. 2009 Oct;129(10):1409-14. doi: 10.1007/s00402-009-0832-x. Epub 2009 Feb 14.
To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis.
In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition.
There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002).
In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results.
确定三种不同局部注射方式治疗外侧上髁炎的有效性。
在一项关于外侧上髁炎的前瞻性随机研究中，75例患者被平均分为A、B、C三组（n = 25），并采用三种不同的局部注射方法进行治疗。A组患者接受局部注射类固醇（1 mL曲安奈德）联合局部麻醉剂（1 mL利多卡因）治疗，B组患者接受注射局部麻醉剂（1 mL利多卡因）联合点刺技术治疗，C组患者接受局部注射类固醇（1 mL曲安奈德）联合局部麻醉剂（1 mL利多卡因）及点刺技术治疗。通过使用10厘米视觉模拟量表（VAS）测量活动时的肘部疼痛，并根据Verhaar等人的标准采用评分系统评估治疗满意度，在注射后3周和6个月时进行评估，并与治疗前情况进行比较。
6个月时，三组之间的成功结果存在显著差异（P = 0.006）。使用局部类固醇+点刺注射技术的C组中，84%的患者获得了优异的结果，而A组和B组患者的这一比例分别为36%和48%。与A组（P = 0.002）和B组（P = 0.011）相比，C组的成功结果在统计学上更高。在所有组中，与治疗前情况相比，3周和6个月随访时疼痛（VAS）明显更低。与其他组相比，C组在6个月随访时测量的VAS明显更低（P = 0.002）。
在外侧上髁炎的治疗中，皮质类固醇注射与点刺相结合比单独使用皮质类固醇注射或点刺注射更有效，并且能产生更好的临床效果。
