Autologous tenocyte injections for tennis elbow
Autologous tenocyte injections (ATI) are a relatively new, novel approach to treating recalcitrant tendon pathologies that have failed conservative management. An initial study published in 2013 by Wang et al defined this new procedure and found a significant improvement in all outcomes at 12months. The current paper discusses the results of a 4 year follow up of the same subjects and found that the successful outcomes were maintained.
Chronic lateral epicondylalgia is characterised by increased extracellular matrix, collagen bundle breakdown and tenocyte apoptosis (cell death) and autophagy (cell degradation). The initial study conducted by Wang and colleages described an autolgous tenocyte injection whereby a patellar tendon needle biopsy is taken and the tendon cells are expanded by in vitro culture. Tenocytes are then injected on a single occasion into the extensor carpi radialis brevis tendon.
3 to 5 year follow up was available for 15 out of 17 patients (1 underwent surgery and 1 died of unrelated causes). Pain improved by 86% at 1 year follow up and 78% at final follow up. Grip strength improved by 132% at 1 year and 208% at final follow up. ATI is a promising treatment for recalcitrant tendinopathies. Future studies should include control subjects and cost-effectiveness measures in other tendons.
> From: Wang et al., Am J Sports Med 43 (2015) 1775-1783(Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.