Yoon Eun-Ji, Lee Jung-Woo, Kim Jong-Ho
Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Medicine (Baltimore). 2024 Dec 20;103(51):e41002. doi: 10.1097/MD.0000000000041002.
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.
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.
The patients were diagnosed with refractory lateral epicondylitis using ultrasonography and magnetic resonance imaging (MRI).
We performed injections of a mixture of ADM and LRPRP into the full-thickness tear of the common extensor tendon.
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.
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.
外侧上髁炎，通常称为网球肘，是一种慢性疾病，其特征为外侧上髁附着点处的肌腱病。对于难治性外侧上髁炎，有多种治疗方法可供选择，从保守治疗到手术治疗。最近，富血小板血浆（PRP）注射已显示出治疗这种疾病的有效性。本研究旨在评估注射异体真皮基质（ADM）和富白细胞PRP（LRPRP）混合物对肌腱再生的有效性。
一名59岁男性和一名62岁男性，均患有伸肌总腱全层撕裂，尽管之前接受了包括类固醇注射、体外冲击波治疗、物理治疗和药物治疗在内的多种保守治疗，但肘部仍持续疼痛。
使用超声和磁共振成像（MRI）对患者进行诊断，确诊为难治性外侧上髁炎。
我们将ADM和LRPRP的混合物注射到伸肌总腱的全层撕裂处。
术后一年，视觉模拟评分法疼痛评分、患者自评网球肘评估评分、手臂、肩部和手部快速残疾评分以及Nirschl评分均较基线有显著改善。在病例1中，注射后6个月和12个月获得的MRI扫描显示伸肌总腱全层撕裂处的肌腱完整性有所改善。在病例2中，注射后6个月的MRI也观察到了类似的改善。
在肘部伸肌总腱全层撕裂部位注射ADM和LRPRP的混合物可增强肌腱完整性。这种治疗方法还可改善难治性外侧上髁炎患者的功能状态。
