Erdem AKTAŞ, Barış YILMAZ, Baybars ATAOĞLU, Murat ARIKAN, Güray TOĞRAL, Murat İLİKMEN

Dirençli Lateral Epikondilit Tedavisinde Trombositten Zengin Plazma ile Kombine Steroid Enjeksiyonunun Etkinliği

AMAÇ: Lateral epikondilit tedavisinde, otolog trombositten zengin plazma (TZP) ile kombine steroid enjeksiyonu yapılan hastalarda el kavrama gücü, ağrı ve hasta memnuniyeti sonuçlarının değerlendirilmesi.YÖNTEMLER: Unilateral dirençli lateral epikondilit tanısı alan, ortalama yaşı 42.6 (23-62), 26 erkek, 58 kadın toplam 84 hastaya uygulanan 2 farklı tedavi yöntemi retrospektif olarak incelendi. Extensor carpi radialis brevis origosuna 1 hafta ara ile lokal steroid (0,5ml Bethametasone+0.25 ml Prilokain) ve TZP uygulanan hastalar grup 1'e dahil edilirken, grup 2'ye aynı lokalizsayona sadece TZP enjeksiyonu uygulanan hastalar dahil edildi. Hastaların tedavi öncesi ve sonrası 15-30 ve 60. günde kaydedilen el kavrama güçleri ve Verhaar fonksiyonel skorları değerlendirildi.BULGULAR: Grup 1'deki hastaların kavrama gücü tedavi öncesi ortalama 0.42±0.17 (0.18-0.63) bar iken, tedavi sonrası 60. günde ortalama 0.68±0.11(0.38-0.84), grup 2'de kavrama gücü tedavi öncesi ortalama 0.45±0.15 (0.19-0.67) iken tedavi sonrası 0.66±0.10 (0.44-082) bar ölçüldü. Grup 1 el kavrama gücünda artış yüzdesi 15 ve 30. günlerde grup 2'ye oranla anlamlı olarak yüksek bulunurken 60. günde 2 grup arasında anlamlı fark bulunmadı (p=0.277).Verhaar skoru, grup 1'de grup 2'ye oranla 15 ve 30. günlerde anlamlı olarak yüksek iken 60. günde fark bulunamadı.SONUÇ: Tek başına TZP uygulamasına göre, steroid enjeksiyonunu takiben yapılan TZP, azalan el kavrama gücünün erken dönemde geri kazanılması gerekli olan vakalarda güvenli ve etkili bir yöntem olarak tercih edilebilir.

Anahtar Kelimeler:

Trombositten Zengin Plazma, Lateral Epikondilit, El Kavrama Gücü

The Efficacy of Platelet Rich Plasma Combined with Steroid Injection in the Treatment of Resistant Lateral Epicondylitis

OBJECTIVE: To evaluate the impact of autologous platelet rich plasma (PRP) combined with steroid injection on hand grip strenght, pain and patient satisfaction in the treatment of lateral epicondylitis.METHODS: 84 patients, mean age 42.6 (23-62) years, diagnosed with unilateral resistant lateral epicondylitis was evaluated retrospectively. Group1 consisted of patients treated with local steroid injection (0,5ml Bethametasone+0.25 ml Prilokain) and PRP within 1 week interval to extensor carpi radialis brevis origo while group 2 consisted of patients who were subjected to single dose local PRP injection to the same localisation. Pretreatment and posttreatment 15-30-60 day hand grip strenght and Verhaar functional score data were evaluated.RESULTS: Mean pretreatment grip strenght of group1 patients were 0.42±0.17 (0.18-0.61) bar whereas posttreatment day 60 increased to 0.68±0.11(0.50-0.85). Group 2 mean pretreatment grip strenght was found to be 0.45±0.15 (0.19-0.84) bar, whereas posttreatment day 60 increased to 0.66±0.10 (0.44-082). Compared to group 2, the percentage of grip strenght increase in group 1 was significantly higher at days 15 and 30, whereas there was no difference at day 60 between groups. (p=0.277). Compared to group 2, Verhaar scores were found to be higher in group1 at days 15 and 30, whereas there was no difference between groups at day 60.CONCLUSION: Compared to PRP alone, steroid injection 1 week prior PRP administration can be preferred as an effective and safe method in cases which early maintanance of decreased grip strenght is mandatory.

Keywords:

Platelet Rich Plasma, Lateral Epicondylitis. Hand Grip Strenght,

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