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Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial

  • Orthopaedic Outcome Assessment
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Abstract

Background

To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis.

Methods

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.

Results

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).

Conclusion

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.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Medical Faculty, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey

    Yunus Dogramaci, Aydiner Kalaci, I. Gokhan Duman & A Nedim Yanat

  2. Department of Community Medicine, Medical Faculty, Mustafa Kemal University, Antakya, Hatay, Turkey

    Nazan Savaş

Authors
  1. Yunus Dogramaci
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  2. Aydiner Kalaci
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  3. Nazan Savaş
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  4. I. Gokhan Duman
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  5. A Nedim Yanat
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Correspondence to Yunus Dogramaci.

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Dogramaci, Y., Kalaci, A., Savaş, N. et al. Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial. Arch Orthop Trauma Surg 129, 1409–1414 (2009). https://doi.org/10.1007/s00402-009-0832-x

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  • DOI: https://doi.org/10.1007/s00402-009-0832-x

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