Ozturan Kutay E, Yucel Istemi, Cakici Husamettin, Guven Melih, Sungur Ibrahim
Department of Orthopedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey.
Orthopedics. 2010 Feb;33(2):84-91. doi: 10.3928/01477447-20100104-09.
Lateral epicondylitis is a common disorder characterized by pain and tenderness over the lateral epicondyle. It occurs most frequently as a result of minor, unrecognized trauma during sports activities and occupation-related physical activities. The goal of this study was to evaluate the short-, medium-, and long-term effects of corticosteroid injection, autologous blood injection, and extracorporeal shock wave therapy in the treatment of lateral epicondylitis.Sixty patients (32 women, 28 men) with lateral epicondylitis were randomly divided into 3 groups: group 1 received a corticosteroid injection; group 2, an autologous blood injection, and group 3, extracorporeal shock wave therapy. Thomsen provocative testing, upper extremity functional scores, and maximal grip strength were used for evaluation. Outcomes were assessed at 4, 12, 26, and 52 weeks. Corticosteroid injection gave significantly better results for all outcome measures at 4 weeks; success rates in the 3 groups were 90%, 16.6%, and 42.1%, respectively. Autologous blood injection and extracorporeal shock wave therapy gave significantly better Thomsen provocative test results and upper extremity functional scores at 52 weeks; the success rate of corticosteroid injection was 50%, which was significantly lower than the success rates for autologous blood injection (83.3%) and extracorporeal shock wave therapy (89.9%). Corticosteroid injection provided a high success rate in the short term. However, autologous blood injection and extracorporeal shock wave therapy gave better long-term results, especially considering the high recurrence rate with corticosteroid injection. We suggest that the treatment of choice for lateral epicondylitis be autologous blood injection.
肱骨外上髁炎是一种常见疾病，其特征为肱骨外上髁处疼痛和压痛。它最常因体育活动和职业相关体力活动中轻微、未被察觉的创伤而发生。本研究的目的是评估皮质类固醇注射、自体血注射和体外冲击波疗法治疗肱骨外上髁炎的短期、中期和长期效果。60例肱骨外上髁炎患者（32例女性，28例男性）被随机分为3组：第1组接受皮质类固醇注射；第2组接受自体血注射；第3组接受体外冲击波疗法。采用汤姆森激发试验、上肢功能评分和最大握力进行评估。在4周、12周、26周和52周时评估结果。在4周时，皮质类固醇注射在所有结果指标上均取得了明显更好的效果；3组的成功率分别为90%、16.6%和42.1%。在52周时，自体血注射和体外冲击波疗法在汤姆森激发试验结果和上肢功能评分方面明显更好；皮质类固醇注射的成功率为50%，显著低于自体血注射（83.3%）和体外冲击波疗法（89.9%）的成功率。皮质类固醇注射在短期内成功率较高。然而，自体血注射和体外冲击波疗法的长期效果更好，尤其是考虑到皮质类固醇注射的高复发率。我们建议肱骨外上髁炎的首选治疗方法是自体血注射。
