Comparing Injection Treatments for Tennis Elbow
Research type
Research Study
Full title
A Prospective, Controlled, Randomised, Double Blind, Single Centre Study, Comparing the Effectiveness of Physiotherapy and Image Guided Injection of the Lateral Epicondyle of the Common Extensor Tendon with either Sodium Hyaluronate with Mannitol (Ostenil Plus·), Platelet Rich Plasma (PRP), or Sham Injection on Pain and Function in Patients with Lateral Epicondyle Tendinosis.
IRAS ID
223134
Contact name
Adam Watts
Contact email
Sponsor organisation
TRB CHEMEDICA (UK) LTD
Duration of Study in the UK
5 years, 0 months, 2 days
Research summary
Tennis elbow is one of the most common musculoskeletal problems affecting the arm and is thought to be mainly due to overuse of the muscles that extend the wrist. The pain arises from the lateral epicondyle of the humerus, where the tendons of the wrist extensor muscles attach.
There are many treatment options available for tennis elbow including oral medication, physiotherapy and injection therapy. Surgical options are reserved for those who fail to respond to more conservative treatments.
Physiotherapy is a widely used, non-invasive treatment option for the management of tennis elbow. Research has shown that in the longer term, physiotherapy is superior to corticosteroid injection in the treatment of tennis elbow and a meta-analysis of published research concluded that Platelet Rich Plasma injection and Hyaluronic Acid injection are superior to corticosteroid for long term pain relief in tennis elbow.
At present there is not enough evidence to indicate what the ‘Gold Standard’ treatment for tennis elbow is, and more research is therefore needed to help guide decision-making. The aim of this study is therefore to examine the effects of injection therapy in addition to physiotherapy treatment, in comparison to physiotherapy and a control injection on pain and function in patients with tennis elbow.
All participants in this study will undergo a structured, specifically designed, class-based physiotherapy intervention, in addition to being randomly allocated to receive one of the following three types of injection: (a) a control injection whereby a needle is inserted into the skin but no therapeutic substance is injection, (b) a single therapeutic injection of platelet-rich plasm or (c) a single therapeutic injection of hyaluronic acid.
Baseline data will be collected at the time of recruitment and participants will be followed up at 3 months and 12 months post treatment. Outcomes will be assessed using various patient-reported outcome measures in addition to clinical examination. The primary outcome for this study is the improvement in the quick DASH score at 12 months post-treatment compared to baseline.REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
18/NW/0035
Date of REC Opinion
15 Mar 2018
REC opinion
Further Information Favourable Opinion