USG-guided injection of corticosteroid for lateral epicondylitis does not improve clinical outcomes: a prospective randomised study

Background Corticosteroid injection used to be the treatment of choice for lateral epicondylitis. Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinica...

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Veröffentlicht in:Archives of orthopaedic and trauma surgery 2017-05, Vol.137 (5), p.601-606
Hauptverfasser: Gulabi, Deniz, Uysal, Mehmet Ali, Akça, Ahmet, Colak, Ilker, Çeçen, Gultekin Sıtkı, Gumustas, Seyitali
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container_end_page 606
container_issue 5
container_start_page 601
container_title Archives of orthopaedic and trauma surgery
container_volume 137
creator Gulabi, Deniz
Uysal, Mehmet Ali
Akça, Ahmet
Colak, Ilker
Çeçen, Gultekin Sıtkı
Gumustas, Seyitali
description Background Corticosteroid injection used to be the treatment of choice for lateral epicondylitis. Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinical study was to compare the clinical therapeutic effects of blinded and USG-guided corticosteroid injection therapy in lateral epicondylitis. Patients and methods Forty patients with chronic lateral epicondylitis were included in this clinical trial. The patients were randomly allocated to blinded group or USG-guided injection group according to a computer-generated randomisation list. All blinded injections were administered by an orthopaedic surgeon and all ultrasound-guided injections were made by a radiologist experienced in this technique. All patients were injected under aseptic conditions using 40 mg/2 mL methylprednisolone acetate. The outcomes of both treatments were assessed by an independent assessor at pre-injection, then at 6-week and 3- and 6-month follow-up assessments. The assessor evaluated the q-DASH, VAS, and grip strength scores. Results No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6 weeks and 3 and 6 months post-injection. No statistically significant difference was determined between the groups in respect of the VAS scores preoperatively and at 6 weeks and 6 months. No systemic or local complications were reported during the treatment. Conclusion There was no statistically significant difference compared to the blinded injection technique, and the mean score differences between the groups are of no clinical relevance.
doi_str_mv 10.1007/s00402-017-2657-3
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Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinical study was to compare the clinical therapeutic effects of blinded and USG-guided corticosteroid injection therapy in lateral epicondylitis. Patients and methods Forty patients with chronic lateral epicondylitis were included in this clinical trial. The patients were randomly allocated to blinded group or USG-guided injection group according to a computer-generated randomisation list. All blinded injections were administered by an orthopaedic surgeon and all ultrasound-guided injections were made by a radiologist experienced in this technique. All patients were injected under aseptic conditions using 40 mg/2 mL methylprednisolone acetate. The outcomes of both treatments were assessed by an independent assessor at pre-injection, then at 6-week and 3- and 6-month follow-up assessments. The assessor evaluated the q-DASH, VAS, and grip strength scores. Results No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6 weeks and 3 and 6 months post-injection. No statistically significant difference was determined between the groups in respect of the VAS scores preoperatively and at 6 weeks and 6 months. No systemic or local complications were reported during the treatment. Conclusion There was no statistically significant difference compared to the blinded injection technique, and the mean score differences between the groups are of no clinical relevance.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-017-2657-3</identifier><identifier>PMID: 28258434</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Elbow ; Elbow - diagnostic imaging ; Female ; Glucocorticoids - administration &amp; dosage ; Humans ; Injections - methods ; Male ; Medicine ; Medicine &amp; Public Health ; Methylprednisolone - administration &amp; dosage ; Middle Aged ; Orthopaedic Surgery ; Orthopedics ; Tennis Elbow - drug therapy ; Treatment Outcome ; Ultrasonography - methods</subject><ispartof>Archives of orthopaedic and trauma surgery, 2017-05, Vol.137 (5), p.601-606</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-349e491edf231c147c84872a6e4f5f3df93a10c41bad5a3cf673180b9a1e58693</citedby><cites>FETCH-LOGICAL-c372t-349e491edf231c147c84872a6e4f5f3df93a10c41bad5a3cf673180b9a1e58693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-017-2657-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-017-2657-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28258434$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gulabi, Deniz</creatorcontrib><creatorcontrib>Uysal, Mehmet Ali</creatorcontrib><creatorcontrib>Akça, Ahmet</creatorcontrib><creatorcontrib>Colak, Ilker</creatorcontrib><creatorcontrib>Çeçen, Gultekin Sıtkı</creatorcontrib><creatorcontrib>Gumustas, Seyitali</creatorcontrib><title>USG-guided injection of corticosteroid for lateral epicondylitis does not improve clinical outcomes: a prospective randomised study</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Background Corticosteroid injection used to be the treatment of choice for lateral epicondylitis. Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinical study was to compare the clinical therapeutic effects of blinded and USG-guided corticosteroid injection therapy in lateral epicondylitis. Patients and methods Forty patients with chronic lateral epicondylitis were included in this clinical trial. The patients were randomly allocated to blinded group or USG-guided injection group according to a computer-generated randomisation list. All blinded injections were administered by an orthopaedic surgeon and all ultrasound-guided injections were made by a radiologist experienced in this technique. All patients were injected under aseptic conditions using 40 mg/2 mL methylprednisolone acetate. The outcomes of both treatments were assessed by an independent assessor at pre-injection, then at 6-week and 3- and 6-month follow-up assessments. The assessor evaluated the q-DASH, VAS, and grip strength scores. Results No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6 weeks and 3 and 6 months post-injection. No statistically significant difference was determined between the groups in respect of the VAS scores preoperatively and at 6 weeks and 6 months. No systemic or local complications were reported during the treatment. 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Uysal, Mehmet Ali ; Akça, Ahmet ; Colak, Ilker ; Çeçen, Gultekin Sıtkı ; Gumustas, Seyitali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-349e491edf231c147c84872a6e4f5f3df93a10c41bad5a3cf673180b9a1e58693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Elbow</topic><topic>Elbow - diagnostic imaging</topic><topic>Female</topic><topic>Glucocorticoids - administration &amp; dosage</topic><topic>Humans</topic><topic>Injections - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Methylprednisolone - administration &amp; dosage</topic><topic>Middle Aged</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Tennis Elbow - drug therapy</topic><topic>Treatment Outcome</topic><topic>Ultrasonography - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gulabi, Deniz</creatorcontrib><creatorcontrib>Uysal, Mehmet Ali</creatorcontrib><creatorcontrib>Akça, Ahmet</creatorcontrib><creatorcontrib>Colak, Ilker</creatorcontrib><creatorcontrib>Çeçen, Gultekin Sıtkı</creatorcontrib><creatorcontrib>Gumustas, Seyitali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Most injections are performed blindly. In the blinded technique, it could be difficult to determine the exact pathological localisation. The purpose of this single-blinded, randomised controlled clinical study was to compare the clinical therapeutic effects of blinded and USG-guided corticosteroid injection therapy in lateral epicondylitis. Patients and methods Forty patients with chronic lateral epicondylitis were included in this clinical trial. The patients were randomly allocated to blinded group or USG-guided injection group according to a computer-generated randomisation list. All blinded injections were administered by an orthopaedic surgeon and all ultrasound-guided injections were made by a radiologist experienced in this technique. All patients were injected under aseptic conditions using 40 mg/2 mL methylprednisolone acetate. The outcomes of both treatments were assessed by an independent assessor at pre-injection, then at 6-week and 3- and 6-month follow-up assessments. The assessor evaluated the q-DASH, VAS, and grip strength scores. Results No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6 weeks and 3 and 6 months post-injection. No statistically significant difference was determined between the groups in respect of the VAS scores preoperatively and at 6 weeks and 6 months. No systemic or local complications were reported during the treatment. Conclusion There was no statistically significant difference compared to the blinded injection technique, and the mean score differences between the groups are of no clinical relevance.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28258434</pmid><doi>10.1007/s00402-017-2657-3</doi><tpages>6</tpages></addata></record>
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source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Adult
Elbow
Elbow - diagnostic imaging
Female
Glucocorticoids - administration & dosage
Humans
Injections - methods
Male
Medicine
Medicine & Public Health
Methylprednisolone - administration & dosage
Middle Aged
Orthopaedic Surgery
Orthopedics
Tennis Elbow - drug therapy
Treatment Outcome
Ultrasonography - methods
title USG-guided injection of corticosteroid for lateral epicondylitis does not improve clinical outcomes: a prospective randomised study
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