ArticleLife (Basel, Switzerland)2026
Ultrasound-Guided Collagen Peptides Injections Combined with Focused Extracorporeal Shockwave Therapy and Therapeutic Exercise in Chronic Partial Common Extensor Tendon Tears at Elbow Lateral Epicondyle: A Retrospective Case Series.
Article in Life (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLateral elbow tendinopathy (LET) is a common upper-limb musculoskeletal disorder causing pain during gripping activities, reduced work capacity, and functional limitation. LET is currently considered a predominantly degenerative condition characterized by collagen disorganization, extracellular matrix changes, neovascularization, and impaired tendon healing.
objectiveTo evaluate short-term clinical and functional outcomes of a multimodal protocol including focused extracorporeal shock wave therapy (f-ESWT), ultrasound-guided intralesional injection of low-molecular-weight peptides (LWPs) derived from hydrolyzed bovine collagen and therapeutic exercise in patients with chronic LET unresponsive to standardized conservative therapy.
methodsThis retrospective observational study included 11 screened patients; 10 completed follow-up. Eligibility required age ≥ 18 years, symptoms ≥ 3 months, positive provocation tests, ultrasound-confirmed common extensor tendon pathology, and incomplete response to prior treatment. All patients received f-ESWT before ultrasound-guided LWPs injection and performed progressive loading exercises. Outcomes included Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength, and clinical provocation tests at baseline (T0; Day 0) and at T1 (Day 51, 30 days after injection).
resultsPRTEE pain improved by 31.2 points (95% CI 22.2-40.2; Cohen's d_z = 2.48) and PRTEE function by 32.6 points (95% CI 26.7-38.5; d_z = 3.95). Mean maximal strength and maximal strength improved by 4.61 kg (95% CI 2.89-6.32) and 4.02 kg (95% CI 2.36-5.68), respectively. Clinical test severity decreased by an estimated 2.5 points (95% CI 2.0-3.0). No adverse events were reported.
conclusionsPatients showed clinically meaningful short-term improvements in pain, function, and strength following the sequential multimodal management strategy. However, the retrospective design, small sample, lack of control group, and short follow-up preclude causal attribution and require confirmation in prospective controlled studies.
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