Tennis Elbow
Conditions
Brief summary
The purpose of this study is to find out functional and electromyographical changes after platelet rich plasma and dextrose injection in chronic lateral epicondylitis.
Detailed description
Both platelet rich plasma (PRP) and dextrose treat chronic lateral epicondylalgia (CLE), mechanically by enhancing tendon cell proliferation, differentiation, and maturation. In fact, hypertonic glucose injection is much cost-effective as compared to PRP. Hence, it is of clinical value to compare the recovery of extensor carpi radialis breveis (ECRB) muscular structure and muscular function between PRP and hypertonic glucose injection. The investigators will measure functional outcome and force gradation after PRP and glucose injection in CLE patients using multi-electromyography, functional score (Disabilities of the Arm, Shoulder and Hand (DASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE)) and force (gripping power and maximal voluntary contraction (MVC) during wrist extension) before and 12 weeks after injection. The hypotheses of this study are 1) lower MVC and greater force fluctuations of a force task in the affected muscle in individuals with CLE; 2) lower discharge rate and higher discharge variability of motor units of a force task in the affected muscle in individuals with CLE than those in the contralateral sound side; 3) the PRP group shows a greater improvement in a visual analog scale (VAS), DASH, PRTEE score, MVC, and the size of force fluctuations than the glucose group after treatment. 4) the PRP group shows a greater discharge rate and lower discharge variability for a force task than the glucose group after treatment.
Interventions
DRUGPlatelet Rich Plasma
Preparing 2 mL of PRP with concentration of 4-6 times the average normal values, 20mL of blood will be first collected from the patient's upper limb cubital vein using an 18G needle. A local subcutaneous anesthesia (2 ml of 1% lidocaine) will be finished by the orthopedist.
DRUGDextrose 50%
The group will use 4 ml of PRP + 4 ml of 0.9% saline -h 2 ml of 1% lidocaine (10-ml syringe).
Sponsors
Chen Yueh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
The control group Inclusion criteria: 1\. The ages of 20-65 years without any neurological or muscular disease.
Exclusion criteria
1\. Systemic disorders such as diabetes, rheumatoid arthritis, or hepatitis The treatment group (Experimental group) Inclusion Criteria: 1. Patients with lateral epicondylitis in the elbow (age: 20-65 years old) 2. Pain unresponsive to 1 of 3 conventional therapy programs (local steroid injections, physical/occupational therapy, nonsteroidal anti-inflammatory medications) 3. History of elbow pain for at least 3 months 4. Elbow pain at least 50 mm/100 mm using a visual analog scale (VAS)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain score on a visual analog scale (VAS) | 12 weeks | a 10 cm line with anchor statements on the left (no pain) and on the right (extreme pain) |
| Disabilities of the Arm, Shoulder and Hand (DASH) score | 12 weeks | scored 0 (no disability) to 100 |
| Patient-Rated Tennis Elbow Evaluation (PRTEE) score | 12 weeks | pain and disability from 0 to 10(0 = no difficulty, 10 = unable to do) |
| Level of force | 12 weeks | extension of maximal voluntary contraction |
| The gradation of muscle force(the surface electromyogram) | 12 weeks | the number of motor units active |
Countries
Taiwan
Contacts
Primary ContactYueh Chen
Outcome results
None listed