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Comparison of the effects of sodium hyaluronate-chondroitin sulphate and corticosteroid in the treatment of lateral epicondylitis: a prospective randomized trial

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Hyaluronic acid and glycosaminoglycans have shown positive effects in improving lateral epicondylitis and other tendinosis conditions. Therefore, we designed a prospective, randomized study to compare the effects of a combined sodium hyaluronate and chondroitin sulfate (HA + CS) injection versus a triamcinolone injection in the treatment of lateral epicondylitis.

Methods

In total, 57 consecutive patients with clinically diagnosed lateral epicondylitis were divided randomly into two groups. In the HA + CS group, 25 patients received a single injection of a solution containing an HA + CS combination and prilocaine HCl, while the 32 patients in the triamcinolone group received a single injection of a solution of triamcinolone and prilocaine HCl. We evaluated the pain and function outcome measures using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire at the beginning of the study, and 3 and 6 months after the injection. Additionally, the Minimum Clinically Important Difference values and percentage changes in the PRTEE subscale scores between the assessments were calculated.

Results

No serious adverse events were reported throughout the study. The mean pain and function scores for the HA + CS and triamcinolone groups had significantly improved at 3 months, but the mean function scores in the HA + CS group were statistically significantly better when compared to the triamcinolone group. At 6 months, both groups had significantly improved mean pain and function scores, compared to the baseline scores; however, the mean pain and function scores in the 6-month HA + CS treatment group were better than in the 6-month triamcinolone group. The relative change for the mean total score in the HA + CS group was much better when compared with the triamcinolone group, and the HA + CS treatment group showed clinically significant improvement when compared with triamcinolone group at 3 and 6 months.

Conclusions

This study supports the idea that for a single injection treatment of patients with lateral epicondylitis, a combination injection of HA + CS may offer better pain benefits for 6 months after injection, when compared to triamcinolone.

Type of study/level of evidence

Level II, Randomized Clinical Trial, Prospective Comparative Study.

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Conflict of interest

This author, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, 02100, Adiyaman, Turkey

    Haci Bayram Tosun, Seyitali Gumustas, Ismail Agir, Abuzer Uludag & Demet Pepele

  2. Department of Orthopaedics and Traumatology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey

    Sancar Serbest

  3. Department of Orthopaedics and Traumatology, Faculty of Medicine, Inonu University, Malatya, Turkey

    Kadir Ertem

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  1. Haci Bayram Tosun
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  2. Seyitali Gumustas
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Correspondence to Haci Bayram Tosun.

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Tosun, H.B., Gumustas, S., Agir, I. et al. Comparison of the effects of sodium hyaluronate-chondroitin sulphate and corticosteroid in the treatment of lateral epicondylitis: a prospective randomized trial. J Orthop Sci 20, 837–843 (2015). https://doi.org/10.1007/s00776-015-0747-z

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  • DOI: https://doi.org/10.1007/s00776-015-0747-z

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