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Botulinum toxin A injection may be effective treatment for chronic lateral epicondylar tendinopathy
Possible selection bias suggests the need for prospective studies in which patients are randomly assigned to undergo single-bone or both-bone fixation.
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Patients with chronic lateral epicondylar tendinopathy that had been resistant to medical treatment experienced effective and well-tolerated treatment when Botulinum toxin A was injected into the extensor carpi radialis brevis muscle, according to results published in The Journal of Bone and Joint Surgery.
Researchers randomly assigned 60 patients with chronic lateral epicondylar tendinopathy that had been resistant to treatment for more than 6 months to receive either a 40-IU injection of Botulinum toxin A or saline solution placebo into the extensor carpi radialis brevis muscle with electromyographic guidance. Researchers identified the percentage of patients whose pain was reduced by greater than 50% at 90 days after injection as the primary assessment criterion. Secondary outcomes assessed at days 30 and 90 included pain intensity, pain frequency, interference with quality of life, sick leave taken, maximum grip strength and side effects. Researchers also recorded the number of participants per group requesting additional therapies at day 90.
Researchers included 29 patients in the Botulinum toxin A group and 28 patients in the placebo group in the day-90 analysis. Results showed a greater than 50% reduction in initial pain intensity at day 90 among 51.7% and 25% of patients in the Botulinum toxin A group and placebo group, respectively. Patients who received Botulinum toxin A had significantly lower pain intensity and the effect on quality of life at day 90 compared with the placebo group, according to results. Researchers found a 17.2% rate of clinically detected transitory paresis of the third finger on extension with no associated functional impairment in the Botulinum toxin A group.
“BoNT-A may therefore have clinical relevance as a treatment for patients whose pain from chronic lateral epicondylar tendinopathy is resistant to standard medical treatment,” the researchers wrote. – by Casey Tingle
Disclosures: Creuzé reports he received grants from Ipsen. Please see the full study for a list of all other authors’ relevant financial disclosures.