Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are s...Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are supposed to provide symptomatic relief and to help surgical delay intervention. Platelet rich plasma (PRP) is a biological component shown to be beneficial for different orthopedic dysfunctionalities treatment. The presence of GFs in PRPs such as transforming growth factor-β, insulin-like growth factor 1co-stimulate the mesenchymal stem cells and fibroblasts secretions and promotes the fibrin matrix formation which effectively drive the healing process, induces regenerative response and lead to the damage structure repair in orthopedics trauma. Methods: Three groups of a total of 30 patients presenting OA, CT and TE diagnosis, non-responding to corticosteroid, HA and non-steroid anti-inflammatory treatments were randomized to undergo one intra-articular injections of single high dose of PRP. The efficacy of Intra-articular PRP Injections was evaluated before the injection and one month after. The efficiency assessment score was based on [1] Knee injury and Osteoarthritis Outcome Score, [2] Physical Function Short Form (KOOS-PS) Arabic (KSA) version LK 1.0, [3] HOOS-Physical Function Short form (HOOS-PS), and [4] Macdermid patient-rated Tennis Elbow. Results: A significant reduction of pain and a marked improvement in movements was observed in the 3 patient’s groups, PRP-injected patients showed significantly higher values compared with baseline: (p < 0.005 vs baseline), improve functional status and reduce clearly the articular dysfunctions over the time. In our study, single High dose injection of PRP provided an overall superior clinical improvement compared with HA and corticosteroid treatments over the time and the different follow-up checkpoints of the study.展开更多
Overuse injuries of the elbow and forearm are very common in athletes. This study was conducted to evaluate the effect of muscle stretching and deep friction massage with using wrist joint support during management of...Overuse injuries of the elbow and forearm are very common in athletes. This study was conducted to evaluate the effect of muscle stretching and deep friction massage with using wrist joint support during management of tennis elbow. This study included forty patients with tennis elbow divided into two equal groups: the first group with a mean age 38.1 ± 0.294 followed a physical therapy program in form of deep friction massage on the proximal attachment of wrist extensor muscles, the second group with a mean age 37.6 ± 0.253, submitted to stretching exercises of wrist extensors. Both of groups submitted to ultrasonic therapy with wrist splint during treatment period, three sessions per week for six weeks. Outcome measures were universal goniometer, visual analogue scale, and squeezing sphygmomanometer. The results showed that there was a significant improvement in ROM of wrist flexion and wrist extension, and handgrip in second group and it was more than in the first group while no significant difference in pain. This study showed that stretching exercise is more beneficial in the management of patients with tennis elbow.展开更多
Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeleta...Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeletal pain syndrome in the elbow,inducing significant pain and limitation of the function of the upper limb.It affects approximately 1-3%of the population and is frequently seen in racquet sports and sports associated with functional overload of the elbow,such as tennis,squash,gymnastics,acrobatics,fitness,and weight lifting.Typewriters,artists,musicians,electricians,mechanics,and other professions requiring frequent repetitive movements in the elbow and wrists are also affected.LE is a leading causation for absence from work and lower sport results in athletes.The treatment includes a variety of conservative measures,but if those fail,surgery is indicated.This review summarizes the knowledge about this disease,focusing on risk factors,expected course,prognosis,and conservative and surgical treatment approaches.展开更多
Background Conventional ultrasonography or magnetic resonance （MR） imaging is commonly performed to obtain information about the severity of the disease,location of the injury,and differential diagnosis.The aim of t...Background Conventional ultrasonography or magnetic resonance （MR） imaging is commonly performed to obtain information about the severity of the disease,location of the injury,and differential diagnosis.The aim of this research was to investigate the diagnostic confidence of sonoelastography as an adjunct to greyscale ultrasonography in lateral elbow tendinopathy.Methods A single experienced physiatrist performed greyscale ultrasonography and sonoelastography in 28 patients （9 men,19 women; mean age,48.5 years; age range,36-67 years） with unilateral symptoms of lateral elbow tendinopathy; the asymptomatic elbows were used as controls.Greyscale images were described as normal,tendinosis,partialthickness tear,and full-thickness tear.Sonoelastographic images of the common extensor tendon were analyzed qualitatively （scoring of the elastic spectrum） and quantitatively （based on a color histogram）.Results Both the imaging methods had high sensitivity,specificity,and accuracy for diagnosing lateral elbow tendinopathy.Considering the clinical diagnosis of lateral elbow tendinopathy,sonoelastography showed significantly higher diagnostic accuracy （96.4％） than ultrasonography （89.5％,P ＜0.01）.Quantitative analysis showed objective interpretation of the sonoelastographic images that revealed greater intensity of green and blue pixels in symptomatic elbows （P ＜0.01）.Conclusion Sonoelastography increases diagnostic confidence in tennis elbow pathology over greyscale ultrasonography alone and may be an additional powerful diagnostic tool in cases of lateral elbow tendinopathy with inconclusive greyscale ultrasonographic findings.展开更多
文摘Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are supposed to provide symptomatic relief and to help surgical delay intervention. Platelet rich plasma (PRP) is a biological component shown to be beneficial for different orthopedic dysfunctionalities treatment. The presence of GFs in PRPs such as transforming growth factor-β, insulin-like growth factor 1co-stimulate the mesenchymal stem cells and fibroblasts secretions and promotes the fibrin matrix formation which effectively drive the healing process, induces regenerative response and lead to the damage structure repair in orthopedics trauma. Methods: Three groups of a total of 30 patients presenting OA, CT and TE diagnosis, non-responding to corticosteroid, HA and non-steroid anti-inflammatory treatments were randomized to undergo one intra-articular injections of single high dose of PRP. The efficacy of Intra-articular PRP Injections was evaluated before the injection and one month after. The efficiency assessment score was based on [1] Knee injury and Osteoarthritis Outcome Score, [2] Physical Function Short Form (KOOS-PS) Arabic (KSA) version LK 1.0, [3] HOOS-Physical Function Short form (HOOS-PS), and [4] Macdermid patient-rated Tennis Elbow. Results: A significant reduction of pain and a marked improvement in movements was observed in the 3 patient’s groups, PRP-injected patients showed significantly higher values compared with baseline: (p < 0.005 vs baseline), improve functional status and reduce clearly the articular dysfunctions over the time. In our study, single High dose injection of PRP provided an overall superior clinical improvement compared with HA and corticosteroid treatments over the time and the different follow-up checkpoints of the study.
文摘Overuse injuries of the elbow and forearm are very common in athletes. This study was conducted to evaluate the effect of muscle stretching and deep friction massage with using wrist joint support during management of tennis elbow. This study included forty patients with tennis elbow divided into two equal groups: the first group with a mean age 38.1 ± 0.294 followed a physical therapy program in form of deep friction massage on the proximal attachment of wrist extensor muscles, the second group with a mean age 37.6 ± 0.253, submitted to stretching exercises of wrist extensors. Both of groups submitted to ultrasonic therapy with wrist splint during treatment period, three sessions per week for six weeks. Outcome measures were universal goniometer, visual analogue scale, and squeezing sphygmomanometer. The results showed that there was a significant improvement in ROM of wrist flexion and wrist extension, and handgrip in second group and it was more than in the first group while no significant difference in pain. This study showed that stretching exercise is more beneficial in the management of patients with tennis elbow.
文摘Lateral epicondylitis(LE)is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle.This is the most common cause of musculoskeletal pain syndrome in the elbow,inducing significant pain and limitation of the function of the upper limb.It affects approximately 1-3%of the population and is frequently seen in racquet sports and sports associated with functional overload of the elbow,such as tennis,squash,gymnastics,acrobatics,fitness,and weight lifting.Typewriters,artists,musicians,electricians,mechanics,and other professions requiring frequent repetitive movements in the elbow and wrists are also affected.LE is a leading causation for absence from work and lower sport results in athletes.The treatment includes a variety of conservative measures,but if those fail,surgery is indicated.This review summarizes the knowledge about this disease,focusing on risk factors,expected course,prognosis,and conservative and surgical treatment approaches.
文摘Background Conventional ultrasonography or magnetic resonance （MR） imaging is commonly performed to obtain information about the severity of the disease,location of the injury,and differential diagnosis.The aim of this research was to investigate the diagnostic confidence of sonoelastography as an adjunct to greyscale ultrasonography in lateral elbow tendinopathy.Methods A single experienced physiatrist performed greyscale ultrasonography and sonoelastography in 28 patients （9 men,19 women; mean age,48.5 years; age range,36-67 years） with unilateral symptoms of lateral elbow tendinopathy; the asymptomatic elbows were used as controls.Greyscale images were described as normal,tendinosis,partialthickness tear,and full-thickness tear.Sonoelastographic images of the common extensor tendon were analyzed qualitatively （scoring of the elastic spectrum） and quantitatively （based on a color histogram）.Results Both the imaging methods had high sensitivity,specificity,and accuracy for diagnosing lateral elbow tendinopathy.Considering the clinical diagnosis of lateral elbow tendinopathy,sonoelastography showed significantly higher diagnostic accuracy （96.4％） than ultrasonography （89.5％,P ＜0.01）.Quantitative analysis showed objective interpretation of the sonoelastographic images that revealed greater intensity of green and blue pixels in symptomatic elbows （P ＜0.01）.Conclusion Sonoelastography increases diagnostic confidence in tennis elbow pathology over greyscale ultrasonography alone and may be an additional powerful diagnostic tool in cases of lateral elbow tendinopathy with inconclusive greyscale ultrasonographic findings.
