Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Treatment of Refractory Lateral Epicondylitis with Platelet-Rich Plasma

불응성 주관절 외상과염에 대한 혈소판 풍부 혈장 주입 치료의 임상적 결과

  • Ko, Sang-Hoon (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Chae-Chil (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kang, Byeong-Seong (Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Ki-Jae (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Seon-Ho (Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 고상훈 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 이채칠 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 강병성 (울산대학교 의과대학 울산대학교병원 영상의학교실) ;
  • 이기재 (울산대학교 의과대학 울산대학교병원 정형외과학교실) ;
  • 이선호 (울산대학교 의과대학 울산대학교병원 진단검사의학교실)
  • Received : 2010.04.21
  • Accepted : 2010.05.04
  • Published : 2010.06.15
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Abstract

Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.

목적: 주관절 외상과염은 주관절 동통을 유발하는 대표적인 질환 중 하나로 이에 대한 치료 방법은 여러 문헌에서 보고 된 바 있다. 본원에서는 외상과염에 대한 혈소판 풍부 혈장 (Platelet-Rich-Plsma) 주입 치료를 시행한 후 그 임상적 결과를 평가해 보고자 하였다. 대상 및 방법: 2009년 1월부터 2009년 12월까지 본원에서 외상과염으로 진단받은 환자 15명 (남자 5명, 여자 10명)을 대상으로 하였으며, 평균 연령은 43.5세 였다. 모든 환자는 타 병원에서 1년 이상의 물리치료, 약물치료 등의 보존적 치료를 시행 받았으나, 증상호전을 보이지 않아 수술적 치료를 고려하는 환자였다. 대상 환자는 주관절 외상과에 경피적 혈소판 풍부 혈장 농축액 3cc를 1회 주입하였으며, 치료효과의 판정은 휴식 시와 작업 시의 visual analogue scale (VAS), The Patient-Rated Tennis Elbow Evaluation (PRTEE)를 시술 후 4, 12주 후 측정하고 치료 전후를 비교평가 하였다. 결과: 치료 4주, 12주 단기 추시에서 휴식시 통증의 VAS 평균 값은 치료 전 4.6에서 치료 4주째 2.5 12주째 1.8로 개선 되었고, 작업시 통증의 경우 치료 전 7.8에서 치료 4주째 6.2 치료 12주째 4.25로 개선 되었다. PRTEE score 평균 값은 치료 전 60.13에서 치료 4주째 46.12, 12주째 24.6으로 개선 되었다. 결론: 보존적 치료에 반응을 보이지 않는 불응성 주관절 외상과염의 치료에 있어 혈소판 풍부 혈장 주입을 이용한 치료는 효과적인 치료법이며, 수술적 치료를 시행 전 고려 되어야 한다고 사료 된다.

Keywords

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