Injection of an allodermal matrix and leukocyte-rich platelet-rich plasma mixture improved the tendon integrity in cases of full-thickness common extensor tendon tears of the elbow: Two case reports.

RATIONALE

Lateral epicondylitis, commonly known as tennis elbow, is a chronic condition characterized by tendinosis at the insertion site of the lateral epicondyle. Various treatment methods are available, ranging from conservative to surgical options for refractory lateral epicondylitis. Recently, platelet-rich plasma (PRP) injections have shown effectiveness for treating this condition. This study aimed to evaluate the effectiveness of injecting a mixture of allodermal matrix (ADM) and leukocyte-rich PRP (LRPRP) for tendon regeneration.

PATIENT CONCERNS

A 59-year-old man and a 62-year-old man, both with full-thickness tears in the common extensor tendon, presented persistent elbow pain despite undergoing several conservative treatments, including steroid injections, extracorporeal shock wave therapy, physical therapy, and medication previously.

DIAGNOSES

The patients were diagnosed with refractory lateral epicondylitis using ultrasonography and magnetic resonance imaging (MRI).

INTERVENTIONS

We performed injections of a mixture of ADM and LRPRP into the full-thickness tear of the common extensor tendon.

OUTCOMES

One year after the procedure, visual analogue scale pain scores, patient-rated tennis elbow evaluation scores, quick disabilities of the arm, shoulder, and hand scores, and Nirschl scores had all improved significantly from baseline. In case 1, MRI scans obtained at 6 and 12 months postinjection demonstrated improved tendon integrity in full-thickness tear of the common extensor tendon. In case 2, similar improvements were observed on the 6-month postinjection MRI.

LESSONS

Injection of a mixture of ADM and LRPRP at the site of full-thickness tears in the common extensor tendon of the elbow can enhance tendon integrity. This treatment also improves functional status in cases of recalcitrant lateral epicondylitis.