Varshney Ankit, Maheshwari Rajesh, Juyal Anil, Agrawal Atul, Hayer Prabhnoor
Department of Orthopaedics, HIMS, Dehradun, Uttarakhand, India.
Int J Appl Basic Med Res. 2017 Apr-Jun;7(2):125-128. doi: 10.4103/2229-516X.205808.
Elbow epicondylar tendinitis is a common problem for patients whose activities require strong gripping or repetitive wrist movements in the day-to-day activities of life. Histologic specimens from chronic cases confirm that tendinitis is not an acute inflammatory condition but rather a failure of the normal tendon repair mechanism associated with angiofibroblastic degeneration. Tendon regeneration may be improved by injecting autologous growth factors obtained from the patient's own blood. Autologous growth factors can be injected with autologous whole blood or platelet-rich plasma (PRP).
A randomized study with 83 patients was done. The study population comprised two groups. Group A ( = 50) treated with local steroid injection and Group B ( = 33) treated with autologous PRP. Patients were allocated randomly using computer-generated random number table. The base-line evaluation was done using visual analog score (VAS) and modified Mayo performance index for elbow (MAYO). Re-evaluation was after 1, 2, and 6 months of the procedure. Statistical analysis was done using independent -test.
Six months after treatment with PRP, patient's with elbow epicondylitis had a significant improvement in their VAS ( < 0.05) and MAYO ( < 0.05) in contrast to steroid, whereas no statistical difference was found between the two groups at 1 and 2 months after intervention.
Treatment of patients with epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection.
对于那些在日常生活活动中需要有力握持或重复手腕运动的患者来说,肘部肱骨外上髁炎是一个常见问题。慢性病例的组织学标本证实,肌腱炎并非急性炎症状态,而是与血管纤维母细胞变性相关的正常肌腱修复机制的失败。通过注射从患者自身血液中获取的自体生长因子,可能会改善肌腱再生。自体生长因子可以与自体全血或富血小板血浆(PRP)一起注射。
对83例患者进行了一项随机研究。研究人群分为两组。A组(n = 50)接受局部类固醇注射治疗,B组(n = 33)接受自体PRP治疗。使用计算机生成的随机数表对患者进行随机分配。基线评估采用视觉模拟评分(VAS)和改良的肘部梅奥功能指数(MAYO)。在治疗后的1、2和6个月进行重新评估。采用独立t检验进行统计分析。
与类固醇治疗相比,PRP治疗肘部肱骨外上髁炎的患者在治疗6个月后,其VAS(P < 0.05)和MAYO(P < 0.05)有显著改善,而在干预后1个月和2个月时,两组之间未发现统计学差异。
用PRP治疗肱骨外上髁炎患者可减轻疼痛并显著提高功能,超过皮质类固醇注射的效果。