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Background: Extensor muscle strengthening exercises with counterforce bands (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for tennis elbow.Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments.Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9&gt;62.4; G2, 54.3&gt;65.0; G3, 55.7&gt;62.6), and more than group 1 at 12 weeks (G1, 56.9&gt;67.9; G2, 54.3&gt;73.6). The mean depth of the common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385&gt;0.386; G2, 0.332&gt;0.392; G3, 0.334&gt;0.357; 12 weeks: G1, 0.385&gt;0.409; G2, 0.332&gt;0.438; G3, 0.334&gt;0.405 [cm]).Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

daehan'gyeon ju'gwanjeol haghoeji/clinics in shoulder and elbow

Comparison of the effectiveness of extensor muscle strengthening exercise by itself, exercise with polydeoxyribonucleotide injection, and exercise with extracorporeal shockwave therapy in lateral epicondylitis: a randomized controlled trial