DIY cure for tennis elbow

Oct 25 2006

Scientists in the United States have come up with a cure for tennis elbow by using the sufferers own blood.

A team at the Menlo Medical Clinic, Stanford University in California have developed a procedure which involves taking a patient's platelets and injecting them directly into the damaged tendon where the natural healing power of the platelets repairs the torn and frayed areas of the tendon.

The specially-prepared platelets appear to provide more relief than more commonly-used therapies which often fail and surgery is then the only other option left.

Study authors Dr. Allan Mishra and Terri Pavelko, say this is the first in vivo human treatment for chronic severe elbow tendonitis in patients for whom other treatments have failed.

They say ninety-three percent of patients in the study did well, which is as good a result as patients who have tendon surgery.

Mishra says as they are using the patient's own blood, there is very little risk and the whole procedure takes less than an hour.

The researchers say the results of the pilot study indicate the therapy is as effective as surgery, with sustained and significant improvement over time, no side effects, and high patient acceptance.

Tennis elbow (lateral epicondylitis or tendonitis) is not confined to those who play tennis, but is a common problem for people whose activities require strong gripping or repetitive wrist motions.

It is a degeneration of the tendon above the elbow that controls the movements of the wrist and hand; current treatments include rest, nonsteroidal anti-inflammatory drugs, bracing, physical therapy, and injections of corticosteroids (cortisone shots).

However recent studies have questioned their efficacy.

For the study the researchers evaluated 140 patients who had tennis elbow for longer than 3 months.

They all had completed a course of physical therapy and had tried a range of treatments, without relief from the symptoms.

Twenty of the original 140 patients evaluated were enrolled in the study and represented the most severe tendonitis patients who had not improved with time or nonsurgical treatment.

Fifteen had had tennis elbow for 15 months and the average patient age was 48 years and they received a one-time injection of platelet-rich plasma (PRP) into their affected elbow.

Five patients with an average age of 42 years, served as a control group and received a 2 to 3 mL injection of a local anesthetic into the affected elbow.

Twenty-four hours later both groups began a 2-week standardized stretching program and at 4 weeks patients were allowed to return to normal sporting and recreational activities.

Eight weeks after treatment, the PRP patients reported a 60 percent improvement while the control group reported a 16 percent improvement.

After two years, 93 percent of the PRP patients said they were completely satisfied with the treatment, and 7 percent were partially satisfied.

Among the patients who received platelet-rich plasma, most had returned to the normal activities of daily living, and more than 90 percent had returned to work or sporting activities.

Mishra says by taking blood from a different area, concentrating it, and putting it back into an area where there was relatively poor blood supply they were able to help repair the damage.

The study is published in the November issue of The American Journal of Sports Medicine.