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Wei Dong, Hans Goost, Xiang-Bo Lin, Christof Burger, Christian Paul, Zeng-Li Wang, Fan-Lin Kong, Kristian Welle, Zhi-Chao Jiang, Koroush Kabir
BACKGROUND: There are many injection therapies for lateral epicondylalgia but there has been no previous comprehensive comparison, based on the Bayesian method. METHODS: The MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for appropriate literature. The outcome measurement was the pain score. Direct comparisons were performed using the pairwise meta-analysis, and network meta-analysis, based on a Bayesian model, was used to calculate the results of all of the potentially possible comparisons and rank probabilities...
August 2016: British Journal of Sports Medicine
Christoph Weber, Veronika Thai, Katrin Neuheuser, Katharina Groover, Oliver Christ
BACKGROUND: Physical therapy for the treatment of lateral epicondylitis (LE) often comprises movement therapies, extracorporeal shockwave therapy (ECSWT), low level laser therapy (LLLT), low frequency electrical stimulation or pulsed electromagnetic fields. Still, only ECSWT and LLLT have been meta-analytically researched. METHODS: PUBMED, EMBASE and Cochrane database were systematically searched for randomized controlled trials (RCTs). Methodological quality of each study was rated with an adapted version of the Scottish Intercollegiate Guidelines Network (SIGN) checklist...
August 25, 2015: BMC Musculoskeletal Disorders
Luke J Heales, Paul W Hodges, Bill Vicenzino
INTRODUCTION: Musculoskeletal ultrasound (MSUS) imaging is used to investigate features of tendinosis. Recent studies have reported tendon pathology not only in the symptomatic tendon but also in the contralateral asymptomatic tendon of animals and humans with unilateral Achilles tendinopathy. This study assessed the symptomatic and contralateral asymptomatic tendon in unilateral lateral epicondylalgia (LE) for features of tendinosis and compared with a pain-free control. METHODS: Twenty-nine participants with clinically diagnosed unilateral LE and 32 pain-free controls (matched for age, sex, and arm dominance) underwent a blinded bilateral MSUS examination of the common extensor tendon using a standardized protocol...
November 2015: Medicine and Science in Sports and Exercise
Elena M Ilieva, Roumen M Minchev, Nedyalka S Petrova
INTRODUCTION: Lateral epicondylitis, or "tennis elbow", is a relatively common disorder. Various therapeutic modalities have been tried in an attempt to manage the disorder but neither the conservative methods nor the surgical options have proved to be beneficial so far. During the past decade in the USA and European countries and the past several years in Bulgaria, the shock wave therapy (focused and radial) has been introduced as a method of choice in the treatment of chronic tendynopathies...
July 2012: Folia Medica
Allan K Mishra, Nebojsa V Skrepnik, Scott G Edwards, Grant L Jones, Steven Sampson, Doug A Vermillion, Matthew L Ramsey, David C Karli, Arthur C Rettig
BACKGROUND: Elbow tenderness and pain with resisted wrist extension are common manifestations of lateral epicondylar tendinopathy, also known as tennis elbow. Previous studies have suggested platelet-rich plasma (PRP) to be a safe and effective therapy for tennis elbow. PURPOSE: To evaluate the clinical value of tendon needling with PRP in patients with chronic tennis elbow compared with an active control group. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
February 2014: American Journal of Sports Medicine
Josué Fernández-Carnero, César Fernández-de-Las-Peñas, Ana Isabel de la Llave-Rincón, Hong-You Ge, Lars Arendt-Nielsen
OBJECTIVE: The aim of this study was to investigate whether generalized deep tissue hyperalgesia exists in patients with chronic unilateral lateral epicondylalgia (LE). METHODS: A total of 26 LE patients (10 males and 16 females, aged 25 to 63 y) and 20 healthy comparable matched controls (aged 26 to 61 y) were recruited and pressure pain threshold (PPT) was assessed bilaterally over the median, ulnar, and radial nerve trunks, the lateral epicondyle, C5-C6 zygapophyseal joint, and the tibialis anterior muscle in a blind design...
September 2009: Clinical Journal of Pain
Shawn F Kane, James H Lynch, Jonathan C Taylor
The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior. The history should include questions about the onset of pain, what the patient was doing when the pain started, and the type and frequency of athletic and occupational activities. Lateral and medial epicondylitis are two of the more common diagnoses and often occur as a result of occupational activities...
April 15, 2014: American Family Physician
Luke James Heales, Nathan Broadhurst, Rebecca Mellor, Paul William Hodges, Bill Vicenzino
INTRODUCTION: Lateral epicondylalgia (LE) is clinically diagnosed as pain over the lateral elbow that is provoked by gripping. Usually, LE responds well to conservative intervention; however, those who fail such treatment require further evaluation, including musculoskeletal ultrasound. Previous studies of musculoskeletal ultrasound have methodological flaws, such as lack of assessor blinding and failure to control for participant age, sex, and arm dominance. The purpose of this study was to assess the diagnostic use of blinded ultrasound imaging in people with clinically diagnosed LE compared with that in a control group matched for age, sex, and arm dominance...
November 2014: Medicine and Science in Sports and Exercise
Eli T Sayegh, Robert J Strauch
BACKGROUND: Lateral epicondylitis is a painful tendinopathy for which several nonsurgical treatment strategies are used. Superiority of these nonsurgical treatments over nontreatment has not been definitively established. QUESTIONS/PURPOSES: We asked whether nonsurgical treatment of lateral epicondylitis compared with observation only or placebo provides (1) better overall improvement, (2) less need for escape interventions, (3) better outcome scores, and (4) improved grip strength at intermediate- to long-term followup...
March 2015: Clinical Orthopaedics and related Research
Cynthia A Kahlenberg, Michael Knesek, Michael A Terry
Lateral epicondylitis is a common source of elbow pain. Though it is often a self-limited condition, refractory lateral epicondylitis can lead to problems with activities of daily living and sometimes requires sick leave from work. Therefore prompt treatment is essential. Histopathologic studies have suggested that lateral epicondylitis is a tendinopathy, associated with apoptosis and autophagy, rather than a tendonitis associated with inflammation. Although corticosteroids have been used for short-term treatment, recent studies have suggested that they are not helpful and may even be harmful and delay healing in the treatment of lateral epicondylitis...
2015: BioMed Research International
Ronald D Ford, William P Schmitt, Kyle Lineberry, Paul Luce
BACKGROUND: The aim of this study is to compare the outcomes of platelet-rich plasma (PRP) injections to surgical release and decortication for lateral elbow tendinosis within a similar patient population. METHODS: A retrospective chart review was performed on two groups of patients, receiving either PRP injections (n = 28) or surgery (n = 50). Patient demographics, clinical presentation, pain score, worker's compensation status, and previous steroid injections were recorded...
June 2015: Hand: Official Journal of the American Association for Hand Surgery
Allan Wang, Katherine Mackie, William Breidahl, Tao Wang, Ming H Zheng
BACKGROUND: Chronic lateral epicondylitis (LE) induces cell apoptosis and autophagy, which lead to the reduction of tendon-derived cells in the torn tendon. Our previous study has shown that ultrasound-guided autologous tenocyte injection (ATI) to the torn tendon in patients with chronic resistant LE significantly improves pain, function, and structural repair at 1 year. This report is the continued assessment of the clinical outcomes of these patients at mean 4.5-year follow-up. HYPOTHESIS: Improvements in LE clinical function and structural repair after ATI will be maintained at mean 4...
July 2015: American Journal of Sports Medicine
Radosław Lebiedziński, Marek Synder, Piotr Buchcic, Michał Polguj, Andrzej Grzegorzewski, Marcin Sibiński
PURPOSE: Chronic tendinopathy of lateral epicondyle of the humerus, commonly known as "tennis elbow" is one of the most frequent tendinopathies caused by recurrent overload of the muscle origins. The aim of the study was to assess the effectiveness of treating lateral epicondylitis (LE) with autologous conditioned plasma (ACP) and betamethasone injections, and to compare these methods over the course of a one year follow-up. METHODS: Patients were randomly placed into one of into two groups: 53 were treated with ACP, and 46 with 1 ml betamethasone injections and 2 ml of 1 % lignocaine...
November 2015: International Orthopaedics
James K H Luk, Raymond C C Tsang, H B Leung
The pathogenesis and management of lateral epicondylalgia, or tennis elbow, a common ailment affecting middle-aged subjects of both genders continue to provoke controversy. Currently it is thought to be due to local tendon pathology, pain system changes, and motor system impairment. Its diagnosis is usually clinical, based on a classical history, as well as symptoms and signs. In selected cases, additional imaging (X-rays, ultrasound, and magnetic resonance imaging) can help to confirm the diagnosis. Different treatment modalities have been described, including the use of orthotics, non-steroidal anti-inflammatory drugs, steroid injections, topical glyceryl trinitrate, exercise therapy, manual therapy, ultrasound therapy, laser therapy, extracorporeal shockwave therapy, acupuncture, taping, platelet-rich plasma injections, hyaluronan gel injections, botulinum toxin injections, and surgery...
April 2014: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Susan E G Sims, Katherine Miller, John C Elfar, Warren C Hammert
BACKGROUND: Non-surgical approaches to treatment of lateral epicondylitis are numerous. The aim of this systematic review is to examine randomized, controlled trials of these treatments. METHODS: Numerous databases were systematically searched from earliest records to February 2013. Search terms included "lateral epicondylitis," "lateral elbow pain," "tennis elbow," "lateral epicondylalgia," and "elbow tendinopathy" combined with "randomized controlled trial...
December 2014: Hand: Official Journal of the American Association for Hand Surgery
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