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Orthobiologics for the Treatment of Tennis Elbow

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Orthobiologics

Abstract

Lateral epicondylitis (LE) is a common, painful condition which can produce marked disability in the upper limb. Both orthobiologic and non-orthobiologic modalities aim to rapidly restore function and ameliorate pain.

There are many conventional treatments for LE such as NSAIDs, physiotherapy, extracorporeal shockwave therapy, and corticosteroid (CS) injections, but these therapies are often ineffective. The best available evidence indicates that orthobiologic therapies for LE, including injections of platelet-rich plasma (PRP), autologous tenocyte injections, point of care isolation from mixed tissue-derived cells from bone marrow or fat, and autologous conditioned serum all seem to be safe with minimal side effects. The RCTs comparing PRP to CS have demonstrated superior and longer-term efficacy associated with PRP administration. There are unanswered questions on PRP, such as the best composition of the injectate (platelet concentration, leukocyte content, and the need for activation). Additional research needs to be conducted on other orthobiologic therapies to determine their usefulness in the treatment of LE.

Future studies should further highlight safety and adverse events, cost-effectiveness, long-term efficacy, indications, patient selection, standardization of cell harvest and processing procedures, quantitative characterization of the final product injected, and quality management. These efforts are essential to establish and optimize clear clinical indications and benefits for orthobiologic injection therapies.

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Acknowledgments

The authors would like to acknowledge Pam Jackson, PhD for her contribution to this work.

Author information

Authors and Affiliations

  1. Healthpoint Hospital, Abu Dhabi, United Arab Emirates

    William D. Murrell

  2. 411th HC, Jacksonville, FL, USA

    William D. Murrell & Nagib Atallah Yurdi

  3. Saudi German Hospital, Dubai, United Arab Emirates

    Sharmila Tulpule

  4. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Agnes Ezekwesili

  5. Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentistry, Salerno, Italy

    Nicola Maffulli

  6. Queen Mary University of London, Barts and the London School of Medicine and Dentistry Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK

    Nicola Maffulli

  7. New Jersey Regenerative Institute LLC, Cedar Knolls, NJ, USA

    Gerard A. Malanga

  8. Department of Physical Medicine and Rehabilitation, Rutgers University, New Jersey Medical School, Newark, NJ, USA

    Gerard A. Malanga

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  1. William D. Murrell
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  2. Sharmila Tulpule
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  4. Agnes Ezekwesili
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  5. Nicola Maffulli
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  6. Gerard A. Malanga
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Editor information

Editors and Affiliations

  1. Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo

  2. Orthopaedic & Sports Medicine Group, Santa Monica Orthopaedic & Sports Medicine, Santa Monica, CA, USA

    Bert R. Mandelbaum

  3. Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA

    George F. Muschler

  4. Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  5. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

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Murrell, W.D., Tulpule, S., Yurdi, N.A., Ezekwesili, A., Maffulli, N., Malanga, G.A. (2022). Orthobiologics for the Treatment of Tennis Elbow. In: Filardo, G., Mandelbaum, B.R., Muschler, G.F., Rodeo, S.A., Nakamura, N. (eds) Orthobiologics. Springer, Cham. https://doi.org/10.1007/978-3-030-84744-9_15

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  • DOI: https://doi.org/10.1007/978-3-030-84744-9_15

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