Evidence map›Paper›PMID 35022075›Full record

ArticleBMC sports science, medicine & rehabilitation2022

Hyaluronic acid injections for chronic tennis elbow.

Gershon Zinger, Alexander Bregman, Ori Safran, Shaul Beyth, Amos Peyser

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC sports science, medicine & rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.2field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. [Infiltration therapies for lateral epicondylopathy].Orthopadie (Heidelberg, Germany) · 2023
    Review
  6. Tendon injections - upper extremity.Skeletal radiology · 2023
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Gershon ZingerDepartment of Orthopedic Surgery, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, 12 Shmuel Bait Street, 9103102, Jerusalem, Israel. GershonZinger@szmc.org.il.
Alexander BregmanDepartment of Orthopedic Surgery, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, 12 Shmuel Bait Street, 9103102, Jerusalem, Israel.
Ori SafranHadassah Medical Center, Kiryat Hadassah, POB 12000, 91120, Jerusalem, Israel.
Shaul BeythHadassah Medical Center, Kiryat Hadassah, POB 12000, 91120, Jerusalem, Israel.
Amos PeyserDepartment of Orthopedic Surgery, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, 12 Shmuel Bait Street, 9103102, Jerusalem, Israel.
Hadassah Medical Center · ILHebrew University of Jerusalem · ILShaare Zedek Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor most patients, tennis elbow (TE) resolves within 6 months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatments for TE but have usually failed. In this study, we tested the hypothesis that injections with hyaluronic acid (HA) would be effective at reducing pain from chronic TE.

methodsPatients with a minimum of six months of pain from TE and with a pain level of 50 or greater (out of 100) were included in the study. They were randomized equally into one of two treatment groups: injection with HA or injection with saline control. Follow-up was conducted at 3, 6 and 12 months from the initial injection. Both the patient and the examiner at the follow-up visits were blinded to the treatment arm. The primary outcome measure was the visual analog scale (VAS pain) score at one year. Additional outcome measures included the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and Patient Rated Tennis Elbow Evaluation (PRTEE) scores.

resultsEighteen patients were randomized into the HA injection treatment arm, and 17 (94%) completed the study. The average age was 51.9 years, and 10 of the subjects were male. Patients had an average of 28.1 months of pain before entering the study. The VAS score in the HA group decreased from a baseline of 76.4-14.3 at 12 months. All 17 patients in the HA group showed VAS score reductions above the minimal clinically important difference (MCID) of at least 18. The PRTEE score improved from 67 to 28.1. The QuickDASH score improved from 53.7 to 22.5. Follow-up in the saline group was less than 50% and was therefore not used as a comparator.

conclusionsHA injections yielded significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from receiving injections of hyaluronic acid rather than having to undergo surgery.

Indexed as

EpicondylitisHyaluronic acidTendinosisTennis elbow

Identifiers

PMID35022075
PMCPMC8753848
OpenAlexW4206253865

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.