Comparative study between autologous blood versus corticosteroid injection for lateral epicondylitis of elbow

Lateral epicondylitis often known as tennis elbow is a common cause for pain in the lateral side of the elbow. It has been shown that a local injection of autologous blood in a case of lateral epicondylitis provides cellular and humoral factors to the site of lesion and triggers a healing cascade. The aim of this study was to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow.

A single blinded prospective randomized study was performed. Total of 40 patients were deputed sequentially into two groups of 20 patients each, A (Autologous Blood Injection) and B(Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Patients were evaluated before injection and on subsequent consultations at 4 weeks, 12 weeks & 6 months.

Before the injection, the mean VAS scores and Nirschl stages were similar in group A and group B, in group A mean VAS score 7.37 in group B 7.47 with an insignificant P value of 0.74, mean Nirschl stage in group A and group B was 5.84 and 6.05 respectively with P value of 0.45. Group B had better pain relief at 4 weeks post procedure in comparison to group A.

After 4 weeks, VAS score and Nirschl stage started decreasing in group A, but to the contrary in group B average VAS pain score raised from 1.68 to 1.88 and Nirschl stage too increased from 1.50 to 1.84 at 12 weeks & 6 months of follow up of patients respectively.

At the six-month follow-up 90% patients had complete pain relief in group A in comparison to only 45% in group B; Seven out of 20 (35%) patients had recurrence of pain at 6 months of follow up in group B but none of the patients reported recurrence of pain or disability in group A.

Injection of autologous blood is an efficient treatment modality for lateral epicondylitis, which is simple, cheap, with less side-effect and minimum recurrence rate.