Autologous Blood Injection Common Extensor Tendon.

You have been referred to have an autologous blood injection to your common extensor origin tendon at the elbow. The commonest reasons for this are having tendinopathy or a partial tear in the tendon.

The procedure involves taking some blood from a vein in your arm (similar to a blood test) and then injecting it directly into the abnormal part of the tendon, using an ultrasound scanner to ensure accurate placement.

You will have some local anaesthetic injected around the site prior to the blood being injected.

This procedure is undertaken with the intent of healing the damaged tendon.

In order to maximise the chances of this being successful, it is important that we respect the body’s natural healing times.

Adverse effects

The local anaesthetic will keep you comfortable for between 4 and 8 hours after the procedure.Most people experience some degree of soreness in the injected tendon for the first 48 hours after procedure. Some people experience quite a substantial pain flare.

This is considered to be a normal response and is treated with analgesics (Panadol/ panadeine/ panadeine forte ) if required. Usually the mild analgesics are all that is required, but your doctor can provide a prescription for panadeine forte as well. Icing is very effective for this sort of pain.

Adhering to the post procedure guidelines set out below can reduce this soreness significantly.

True complications from autologous blood injection are rare. Bruising and tenderness around the injections site are usually mild. Infection risk is minimised with our technique, but infections have been reported rarely.

There is a theoretical risk of tendon rupture following injection into the tendon. To date, we are only aware of one case in the literature. Again, our post procedure protocols are aimed at reducing this risk even further

Consent forms

To ensure that you are aware of the very small possibility of adverse outcomes, your requirements after your procedure and the costs involved, we will provide you with a consent form to sign and return to reception prior to your procedure.

 

Post injection instructions

• Braces

We do recommend using a tennis elbow brace after your injection, unless a brace has been specifically WORSENING your symptoms previously.

If you do not already have a brace, we do stock them in the clinic or you may find them at your local chemist.

• Activity restrictions

You are still able to do all of your normal daily activities, but we would recommend that you avoid any unnecessary heavy lifting or carrying with your sore arm. You may have previously been doing some strengthening, but this must be stopped at least until you have a review with your doctor. It is, however, important to remember that complete rest and holding the arm still can be just as detrimental as overdoing things.

• Increasing activity

You are not to increase your activity level until you have been reviewed by your doctor, which usually occurs 2 weeks after the injection. A general rule is that you should not do anything that would have been painful before the injection until after you have been reviewed.

• Muscle pain

You may experience some discomfort in the forearm muscles and this is commonly due to spasm of these muscles rather than any issues from the injection into the tendon. You can self manage this with massage.

• Rehabilitation

The key ingredient to success is your rehabilitation. All things going well, this starts after your 2 week review.

If you have any further questions, please discuss these with your doctor.