Kortikosteroid enjeksiyonuna dirençli kronik lateral dirsek epikondiliti olgularynda trombositten zengin plazma (TZP) uygulamalarynyn sonuçlary

Amaç: Bu çaly?manyn amacy daha önce kortikosteroid uygulanmy?, ?ikayetleri geçmemi? veya geçtikten sonratekrar ba?lamy? kronik lateral epikondilitli hastalardaki trombositten zengin plazma (TZP) uygulamalarynyn1 yyllyk klinik sonuçlary bildirmektir. Hastalar ve Yöntem: Daha once lateral epikondilit nedeniyle kortikosteroiduygulanmy? ve ?ikayetleri geçmemi? veya tekrar ba?lamy? 12 hastaya 2010-2012 yyllary arasynda 1 kez TZPuygulandy, hastalar prospektif olarak takip edildi. Y?lem öncesinde birkez, sonrasynda birinci,üçüncü,altyncyve onikinci aylarda (Visual Analog Score) VAS skorlary ve Patient Rated Tennis Elbow Evaluation (PRTEE)skorlary de?erlendirildi. Sonuçlar: Hastalaryn 9u bayan 3ü erkekti. Ya? ortalamasy 48.6 idi. Y?lem öncesiortalama VAS skoru 8.7, PRTEE skorlary ise 83 olarak de?erlendirildi. Y?lem sonrasy 1.ayda ortalama VASskoru 6,6 PRTEE skorlary ise ortalama 61,3, 3. ayda ortalama VAS skoru 3,8 PRTEE skorlary ise ortalama 34,9,6. ayda ortalama VAS skoru 1,85 PRTEE skorlary ise ortalama 19,8, 12. ayda ortalama VAS skoru 1,47 PRTEEskorlary ise ortalama 17.9 olarak de?erlendirildi. 1. yylda hastalar uygulanan tedaviyi de?erlendiriken, 6tanesi çok iyi, 5 tanesi iyi, 1 tanesi kötü olarak de?erlendirdi. Tarty?ma: Literatürde TZPnyn lateral epikondilit,plantar fasiit ve kykyrdak lezyonlaryndaki uygulamalaryyla ilgili umut verici sonuçlar mevcuttur. Bizim 12hastayla yapty?ymyz prospektif çaly?mada kortikosteroid uygulamasyna dirençli lateral dirsek epikondilitiolgularynda TZP uygulamasynyn hastalaryn a?rylaryny azaltty?yny ve fonksiyonlaryny arttyrdy?y izlenmektedir.

Results of Platelet-Rich Plasma (PRP) Applications for Chronic Lateral Elbow Epicondylitis That are Resistantto Corticosteroid Injections

.Aim: The main goal of the study is to present 1-year follow-up results of patients with chronic lateralepicondylitis that are resistant to corticosteroid injections in whom we applied platelet rich plasma (PRP).Material and Methods: We applied PRP once to the patients who did not benefit from corticosteroid injections.We prospectively evaluated patients between 2010 and 2012. We evaluated patients with visual analog score(VAS) and patient rated tennis elbow evaluation (PRTEE) score at the pre-treatment once, post-treatment1st, 3rd, 6th and 12th month follow-ups. Results: Nine patients were female, three was male. The mean ageof patients was 48.6. The average pre-treatment VAS and PRTEE scores were 8.7 and 83 respectively. Theaverage VAS scores improved to 6.6, 3.8, 1.85, 1.47 at the post-treatment 1st, 3rd, 6th, and 12th month followups respectively. The average PRTEE scores improved to 61.3, 34.9, 19.8, 17.9 at the post-treatment 1st, 3rd,6th and 12th month follow-ups respectively. At the 12th month follow-up, six patients rated their treatmentas excellent, five as good, and one as poor. Discussion: There are promising results in the literature regardingPRP applications for lateral epicondylitis, plantar fasciitis, and chondral lesions. In this study, we observedthat pain and function scores of patients that are resistant to corticosteroid injections improved after PRPapplication.

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Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 1300-7416
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1994
  • Yayıncı: SDÜ Basımevi / Isparta