Lateral epikondilit tedavisinde plateletten zengin plazma ve steroid enjeksiyonlarının karșılaștırılması

AMAÇ: Lateral epikondilit tedavisinde kullanılan plateletten zengin plazma ve steroid enjeksiyonlarının karșılaștırmayı amaçladık. YÖNTEM: Çalıșmamızda 50 adet lateral epikondilit tanılı hasta yer aldı. İlk 25 hastaya plateletten zengin plazma, daha sonraki 25 hastaya steroid enjeksiyonu yapıldı. Hastalar 1. ve 3. ayda kontrole çağırılarak, Görsel Analog Skor ve Patient Rated Tenis Elbow Evaluation sistemlerine göre değerlendirildiler. Bulgular enjeksiyon öncesi değerler ile karșılaștırıldı. BULGULAR: Her iki gruba ait birinci ve üçüncü ay sonu Görsel Analog Skor ve Patient Rated Tenis Elbow Evaluation değerleri enjeksiyon öncesi değerlere göre daha düșük tespit edildi. Birinci ayın sonundaki değerlerin steroid grubunda daha düșük olduğu görüldü. Üçüncü ayın sonunda, her iki grubun Görsel Analog Skor ve Patient Rated Tenis Elbow Evaluation değerleri arasında ise anlamlı fark bulunamadı (p>0.05). SONUÇ: Lateral epikondilit tedavisinde kullanılan plateletten zengin plazma ve steroid enjeksiyonlarının etkinliği, birinci ayın sonunda steroid grubunda daha fazlayken, üçüncü ayın sonunda benzerdir.

The comparison platelet-rich plasma and steroid ınjections for the treatment of lateral epicondylitis

AIM: We aimed to compare the use of platelet-rich plasma and steroid injections treatment of lateral epicondylitis. METHODS: We analyzed 50 patients with the diagnosis of lateral epicondylitis. The first of 25 patients received steroid injection and second 25 received platelet-rich plasma. The participants were reevaluated in the following first and third months using the Visual Analog Score and Patient Rated Tennis Elbow Evaluation Scores. The results were compared with the initial values. RESULTS: Both group’s Visual Analog Score and Patient Rated Tennis Elbow Evaluation Score values were found lower than the values before the injections. Although the results were lower in steroid group at the end of the first month, there wasn’t any significant difference between both group’s Visual Analog Score and Patient Rated Tennis Elbow Evaluation Score values at the end of the third month (p>0.05). CONCLUSION: Although steroid injections seem better for the treatment of lateral epicondylitis at the end of first month, they have similar efficiency in comparison with platelet-rich plasma at the end of third month.

Kaynakça

1. Boyer MI, Hastings HI. Lateral tennis elbow: “Is there any science out there?” J Shoulder Elbow Surg 1999;8:481–91. 2. Allander E. Prevalence, incidence and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol 1974;3:145–53.

3. McCormack RR Jr, Inman RD, Wells A, et al. Prevalence of tendinitis and related disorders of the upper extremity a manufacturing workforce. J Rheumatol 1990;17:958–64.

4. Murtagh JE. Tennis elbow. Aust Fam Physician 1988;17:90–5.

5. Boyd HB, McLeod AC Jr. Tennis elbow. J Bone Joint Surg Am 1973;55:1183–7.

6. Nirschl RP, Ashman ES. Elbow tendinopathy, Tennis elbow. Clinical Sports Medicine 2003;22:813–36.

7. Calfee RP, Patel A, DaSilva MF, et al. Management of lateral epicondylitis: current concepts. J Am Acad Orthop Surg 2008;16:19–29.

8. Cyriax J, Troisier O. Hydrocortone and soft-tissue lesions. BMJ 1953;2:966–8.

9. Smidt N, van der Windt DA, Assendelft WJ, et al. Corticosteroid injections, physiotherapy, or a wait-andsee policy for lateral epicondylitis. Lancet 2002;359:657–62.

10. Wong MW, Tang YY, Lee SK, et al. Effect of dexamethasone on cultured human tenocytes and its reversibility by platelet derived growth factor. J Bone Joint Surg Am 2003;85:1914–20.

11. Marx RE. Platelet-rich plasma, evidence to support its use. J Oral Maxillofac Surg 2004;62:489–96.

12. Salemi S, Rinaldi C, Manna F et al. Reconstruction of lower leg skin ulcer with autologous adipose tissue and platelet-rich plasma. J Plast Reconstr Aesthet Surg 2008;61:1565–7.

13. De Mos M, van der Windt AE, Jahr H, et al. Can platelet-rich plasma enhance tendon repair. Am J Sports Med 2008;36:1171–8.

14. Creaney L, Hamilton B. Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med 2008;42:314–20.

15. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 2006;34:1774–8.

16. Creaney L, Wallace A, Curtis M, et al. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy. Br J Sports Med 2011;45:966– 71.

17. Kon E, Filardo G, Delcogliano M, et al. Platelet-rich plasma, new clinical application, a pilot study for treatment of jumper’s knee. Injury 2009;40:598–603.

18. Barrett S, Erredge S. Growth factors for chronic plantar fasciitis. Podiatry Today 2004;17:37–42.

19. Everts PA, Devilee RJ, Brown Mahoney C, et al. Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome. Eur Surg Res 2008;40:203–10.

20. Sánchez M, Anitua E, Andía I. Platelet-rich therapies in treatment of orthopaedic sport injuries. Sports Med 2009;39:345–54.

21. Randelli PS, Arrigoni P, Cabitza P, et al. Autologous platelet rich plasma for arthroscopic rotator cuff repair. Disabil Rehabil 2008;30:1584–9.

22. Peerbooms JC, Sluimer J, Bruijn D, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial, platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 2010;38:255–62.

23. Struijs PA, Kerkhoffs GM, Assendelft WJ, et al. Conservative treatment of lateral epicondylitis brace versus physical therapy or a combination of both. Am J Sports Med 2004;32:462–9.

24. Gaujoux-Viala C, Dougados M, Gossec L. Efficacy and safety of steroid injections for shoulder and elbow tendonitis. Ann Rheum Dis 2009;68:1843–9.

25. Hay EM, Paterson SM, Lewis M, et al. Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care. BMJ 1999;319:964–8.

26. Altay T, Günal I, Oztürk H. Local injection treatment for lateral epicondylitis. Clin Orthop Relat Res 2002;398:127–30.

27. Soomekh DJ. Current concepts for the use of platelet-rich plasma in the foot and ankle. Clin Podiatr Med Surg 2011;28:155–70.

28. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 2004;75:93–9.

Kaynak Göster