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MEDICINA DELLO SPORT
A Journal on Sports Medicine
Official Journal of the Italian Sports Medicine Federation
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,163
Medicina dello Sport 2014 June;67(2):289-95
language: English, Italian
Corticosteroid and hyaluronic acid injection therapy in tennis elbow (lateral epicondylalgia)
Bernetti A. 1, 2, Mangone M. 1, Paoloni M. 1, Di Sante L. 1, Murgia M. 1, Santilli V. 1
1 Board of Physical Medicine and Rehabilitation, Department of Orthopedics, “Sapienza” University, Rome, Italy;
2 “A. Venerando” Institute of Medicine and Sports Science, CONI, Rome, Italy
AIM: Aim of the study was to compare the long-term effectiveness of the infiltration of local corticosteroids versus a protocol of one infiltration of local corticosteroid followed by 3 infiltrations of low molecular weight hyaluronic acid.
METHODS: This prospective study was conducted on 11 patients, practicing tennis as a hobby, who were diagnosed with humeral epicondylitis at our outpatient clinic between June 2012 and June 2013. Patients were randomly assigned into two equal groups. Group 1 received a single peritendinous injection of 1 mL methylprednisolone acetate 40 mg/mL with 0.8 mL lidocaine on the humeral epicondyle. Group 2 patients received a single peritendinous injection of 1 mL methylprednisolone acetate 40 mg/mL with 0.8 mL lidocaine plus an injection of 1 mL of low molecular weight hyaluronic acid 10 days later and once a week for two more times. Patients were evaluated with the Italian version of the Disabilities of the Arm, Shoulder and Hand questionnaire before injection and at the 3 and 6 months follow-up.
RESULTS: We evaluate the patient before the beginning of the treatment, 3 months and 6 months later. There were no significant differences between the two groups with regard to gender, age, follow-up period, symptom duration, involved side and dominant limbs. The DASH scores of Group 2 were significantly lower than those of Group 1 at the 6 months follow-up (P=0.003).
CONCLUSION: Long-term clinical success in the treatment of lateral epicondylitis could depend on the choice of the injection drugs. The injection of methylprednisolone acetate 40 mg/mL with 0.8 mL lidocaine plus injection of 1 mL of low molecular weight hyaluronic acid 10 days later and once a week for two more times appears to be more effective than the single injection of methylprednisolone acetate 40 mg/mL with 0.8 mL lidocaine in the long-term.