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. 2020 May-Jun;28(3):107-110.
doi: 10.1590/1413-785220202803228291.

PROSPECTIVE EVALUATION OF PERIARTICULAR HYALURONIC ACID INFILTRATION FOR THE TREATMENT OF LATERAL EPICONDYLITIS

Guilherme Augusto Stirma  1 , Deginaldo Holanda Chaves  1 , Simone Tortato  1 , Paulo Santoro Belangero  1 , Paulo Henrique Schmidt Lara  1 , Benno Ejnisman  1
Affiliations

PROSPECTIVE EVALUATION OF PERIARTICULAR HYALURONIC ACID INFILTRATION FOR THE TREATMENT OF LATERAL EPICONDYLITIS

Guilherme Augusto Stirma et al. Acta Ortop Bras. 2020 May-Jun.

Abstract
in English, Portuguese

Objective: To prospectively, clinically and functionally follow-up patients previously diagnosed with lateral epicondylitis after periarticular application of hyaluronic acid and analyze the results.

Methods: All patients were previously treated conservatively and had no clinical improvement. Data such as age, positivity for specific tests (Cozen and Mill), visual analogue pain scale (VAS) before and during dorsiflexion of the wrist with resistance, diagnosis time, Mayo Elbow Performance Score was collected. Patients were reevaluated 30 and 90 days after application.

Results: The positivity rates for Cozen and Mill tests were identical, starting at 100%, dropping to 50% after one month, and ending at 41.7% after 3 months. The initial Mayo Elbow Score average was 61.3 points; 85.8 in the first month, remaining at 85 in the third month. VAS in active force situations had the initial average of 8.1; after one month it dropped to 3.8, and 3.6 after three months. At rest, the initial average was 5.9; after one month it decreased to 3 and ended at 2.1 in three months.

Conclusion: Patients showed improvement in pain parameters, in the Mayo Elbow Performance Score standard, but with 25% of failure in satisfaction. Level of evidence IV, Case series.

Objetivo: Acompanhar de maneira prospectiva, clínica e funcionalmente, os pacientes previamente diagnosticados com epicondilite lateral após a aplicação periarticular de ácido hialurônico e analisar os resultados.

Métodos: Todos pacientes foram tratados previamente de maneira conservadora e não obtiveram melhora clínica. Foram coletados idade, positividade nos testes específicos (Cozen e Mill), escala visual analógica da dor (EVA) antes e durante a dorsoflexão contrarresistência do punho, tempo de diagnóstico, Mayo Elbow Performance Score. Os pacientes foram reavaliados após 30 e 90 dias das aplicações.

Resultados: Os índices de positividade para os testes de Cozen e Milll foram idênticos, começaram em 100%, caíram para 50% após 1 mês, e terminaram em 41,7% em 3 meses. A média inicial do Mayo Elbow Score foi 61,3 pontos; 85,8 no primeiro mês e manteve-se em 85 no terceiro mês. A EVA em situações de força ativa teve a média inicial de 8,1; após 1 mês caiu para 3,8, e 3,6 em 3 meses. Em repouso, a média inicial foi 5,9; após 1 mês diminui para 3, e terminou com 2,1 em 3 meses.

Conclusão: Os pacientes apresentaram melhora nos parâmetros de dor, no padrão Mayo Elbow Performance Score, mas com 25% de falha na satisfação. Nível de evidência IV, Série de casos .

Keywords: Hyaluronic Acid; Mayo Elbow Performance Score; Tennis Elbow.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Infiltration of periarticular hyaluronic acid.
Figure 2
Figure 2. Evolution for the distribution of the Cozen test.
Figure 3
Figure 3. Evolution for the VAS score
See this image and copyright information in PMC

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