ABSTRACT
Background: Tennis elbow or lateral epicondylitis is a common complaint involving about a 3-5% cases in a community. Non-surgical treatment is effective in 80% of cases. Recent studies have shown the effect of autologous blood on improving the pain and function of affected patients. The present study aimed to compare the effectiveness of steroid and autologous blood local injection in controlling pain and disability in the short and long term. Methods: The present study was a clinical trial conducted in Shahid Beheshti Hospital of Babol. A total of 60 patients were divided into 3 groups; A group injected at the site of lateral epicondylitis with steroid (methylprednisolone acetate-40mg) and another group with autologous blood (2ml of venous blood), and the other group used a brace for 3 weeks. Patients were followed-up for 15, 30, and 90 days, and the PRTEE assessment questionnaire assessed their pain and disability. Results: On the 15th day, there was no statistically significant difference in pain and function in the three groups, although the injectable groups were relatively more effective. On the 30th day (p=0.001), the local corticosteroid was significantly better than the autologous blood group, while on the 90th day (p<0.001), autologous blood was significantly better than the local corticosteroid. The average day, in which 25% improvement was gained, was lower in the autologous blood transfusion group. Conclusion: Regarding the long-term effect of autologous blood on corticosteroid injections, it was recommended as a lateral epicondylitis treatment.
ABSTRACT
Background: Individual variability in the length and thickness of hamstring tendon autografts is a serious drawback in using these tendons for anterior cruciate ligament reconstruction (ACLR). In this study, we aimed to determine the correlation between the anthropometric parameters and the size of hamstring tendon autografts. Methods: In a cross-sectional study, 52 male ACLR candidates were included. The length of semitendinosus and gracilis tendons and the diameter of single, doubled, and quadrupled tendons were measured. A graft sizing block device with an incremental size change of 0.5 mm (range 4.5-12) was used to measure the tendon graft diameter. The evaluated anthropometric parameters included age, gender, height, weight, BMI, thigh length and diameter, calf length, thigh-to-calf ratio, wrist diameter, and ankle diameter. A Pearson's or Spearman's correlation coefficient test was used for evaluating the correlation of anthropometric factors with graft characteristics. Results: The mean age of the patients was 27.1 ± 6.4 years. The semitendinosus length was significantly correlated with the patient's height (r = 0.373, P = 0.007), thigh length (r = 0.364, P = 0.009), and calf length (r = 0.340, P = 0.015). The gracilis length was significantly correlated with thigh length (r = 0.278, P = 0.049). The mean quadruple diameter was 8.56 ± 1.15 mm (range 6.5-11). The quadruple diameter was significantly correlated with the thigh length (r = 0.283, P = 0.044). No other significant correlation was found between the tendons' size and evaluated anthropometric parameters. Conclusion: Thigh length was correlated with the semitendinosus length, gracilis length, and quadruple diameter. Therefore, it could be regarded as the most consistent and promising anthropometric factor in the prediction of hamstring autograft size.
ABSTRACT
Background: We aimed to compare the efficacy of local injection therapies for lateral epicondylitis in a Bayesian framework. Methods: We searched the Embase, PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and ProQuest, for randomized controlled trials published from inception to February 2021 in any languages. The injection therapies included corticosteroids (CSs), autologous blood (AB), botulinum toxin (BT), and platelet-rich plasma (PRP). Placebo was the reference group for comparison. The study outcomes were pain, function, and strength, at 1, 3 and 6 months after injection. Results: Thirty-one trials were finally included in this network meta-analysis, comprising 1,948 patients. In the first month of treatment, CS and BT were more efficacious than placebo in terms of pain reduction, and CS was superior to BT. In the same follow-up time, CS was also superior to placebo in terms of functional improvement. In the third month of treatment, BT was the only intervention that was more efficient than placebo in pain relief. With regard to functional improvement, none of the treatments significantly had a higher effectiveness than placebo in the same period. Moreover, no therapies were found to be more efficient than placebo in the sixth month of treatment in terms of any study outcomes. In addition, we did not identify an intervention superior to placebo regarding strength improvement outcome in any times of follow-up. Conclusion: CSs and BT are efficient in improving clinical outcomes of lateral epicondylitis in the short term. Also, the efficacy of CSs seems to be greater than BT. On the other hand, AB and PRP were not significantly more efficient than placebo in any times of follow-up.
ABSTRACT
PURPOSE: The aim of this study was to evaluate the frequency of depressive and anxiety disorders in patients with carpal tunnel syndrome (CTS) after surgery in comparison with normal individuals. MATERIALS AND METHODS: This cross-sectional analytical case-control study conducted on patients who underwent surgery with a diagnosis of carpal tunnel syndrome. In the first group, 35 patients with CTS who underwent surgery were randomly selected and evaluated for anxiety and depression with two standard questionnaires - of CES-D (Center for Epidemiologic Studies Depression) and S-TAI (Spielberger State-Trait Anxiety Inventory). The second group of 35 normal people were randomly selected and examined after matching the age and sex. The data were compared and analyzed using SPSS V.22 software. RESULTS: The mean score of Spielberger state and trait anxiety and depression in the case group was higher than the control group (P < 0.001 and P = 0.003 respectively). In both age groups (< 40 and > 40 years) the level of state and trait anxiety and depression was significantly higher in case than the control group. In women, the level of state and trait anxiety and depression was significantly higher in the case group than in the control group, but in men, only trait anxiety was significant. CONCLUSION: The anxiety and depression disorders were more common in patients undergoing CTS than in normal individuals. Therefore, it is necessary to study the psychological status of these patients in the pre-discharge period and pay attention to its predictors in order to plan appropriate interventions.
