الفهرس | Only 14 pages are availabe for public view |
Abstract Tennis elbow (latral epicodylitis) is a common problem that causes many symptoms such as pain in lateral aspect of the elbow, restriction of movement and impaired activities of daily life. There are a lot of theories that explain the causes of that symptoms such as the tendinogenic theory which relate the symptoms to degeneration of the origin of the extensor carpi radialis brevis, the articular theory which relate the symptoms to irritation of synovial membrane secondary to weakened fibers of common tendon due to trauma, stress or aging process, bursitis, traumatic periostitis and chondromalecia of the capitulum lastly the neurogenic theory which suggests an association between tennis elbow and entrapment of the posterior interosseous nerve by a fibrous arch in the superficial head of the supinator muscle (the arcade of Frohse) and the anterior aspect of the deep apponeurosis of the extensor carpi radialis brevis. Many modalities of treatment were prescribed to relieve the symptoms such as rest, nonsteroidal anti-infl ammatory drugs (NSAIDs), bracing, physical therapy and corticosteroid injection. Newer treatment modalities have been tried, such as extracorporeal shock wave treatment, iontophoresis, and injection of botulism toxin. In case of lack of response to conservative treatment, the last resort is surgery with the primary objective of relieving pain. One novel treatment strategy is the use of local injection of platelet rich plasma. Preparation of platelet-rich plasma involves centrifugation of autologous blood to separate and concentrate platelets. The plateletrich plasma fraction may then be activated prior to injection by addition of excess calcium to saturate all platelet receptors. Alternatively, the platelet-rich plasma fraction may be naturally activated after injection when coming in contact with local tissues. |