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Autologous blood v Saline v Steroid for LE

Discussion in 'Pain Medicine' started by lobelsteve, Aug 4, 2011.

  1. lobelsteve

    lobelsteve SDN Lifetime Donor
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    Comparison of Autologous Blood, Corticosteroid, and Saline Injection in the Treatment of Lateral Epicondylitis: A Prospective, Randomized, Controlled Multicenter Study
    Jennifer Moriatis Wolf, MD, Kagan Ozer, MD, Frank Scott, MD, Michael J.V. Gordon, MD, Allison E. Williams, PhD
    Received 12 October 2010; accepted 6 May 2011. published online 27 June 2011.

    Abstract Full Text PDF References
    Purpose
    We compared saline, corticosteroid, and autologous blood injections for lateral epicondylitis in a prospective, blinded, randomized, controlled trial. The null hypothesis was that patient-rated outcomes after autologous blood injection would not be superior to corticosteroid and saline injections.

    Methods
    Patients with clinically diagnosed lateral epicondylitis of less than 6 months' duration were randomized into 1 of 3 groups to receive a 3-mL injection of saline and lidocaine, corticosteroid and lidocaine, or autologous blood and lidocaine. Of 34 subjects who enrolled, 28 completed follow-up. A total of 10 were randomized to the saline group, 9 to the autologous blood group, and 9 to the steroid group. Every participant had 3 mL blood drawn, and the injection syringe was foil-covered to prevent the subject from knowing the contents. The primary outcome measure was the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Patients completed a pain visual analog scale, DASH, and the Patient-Rated Forearm Evaluation before injection and at 2 weeks, 2 months, and 6 months after injection. We performed statistical analysis using repeated measures of analyses of variance.

    Results
    There were no significant differences in DASH scores among the 3 groups at 2- and 6-month follow-up points, with the mean scores for saline at 20 and 10, respectively, compared with 28 and 20 for autologous blood and 28 and 13 for steroid injections. Secondary measures showed similar findings, with outcomes scores showing improvement in all 3 groups.

    Conclusions
    In this prospective, randomized, controlled trial, autologous blood, corticosteroid, and saline injection provide no advantage over placebo saline injections in the treatment of lateral epicondylitis. Patients within each injection group demonstrated improved outcome scores over a 6-month period.
     
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  3. specepic

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    another crappy study the insurance companies can use against us...n of about 10 per group, NOT prp but just blood, no U/S guidance mentioned so maybe half actually got there, and on and on

    did BC/BS pay for the study? ;)
     
  4. lobelsteve

    lobelsteve SDN Lifetime Donor
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    The Journal of Hand Surgery, 08/04/2011

    Wonder if their goal was to study this or say that nothing but surgery works.
     
  5. specepic

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    Agree on the latter, although from what I hear surgeons don't need guidance b/c they know the anatomy so much better than us plebes
     
  6. bedrock

    bedrock Member
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    Exactly. Compare that to US guided PRP injection with a decent n. Then I might believe the results.
     
  7. Jcm800

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    it is amazing how they have x-ray vision...
     

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