Autologous Blood Injections in Soft Tissue Complaints

Dr Cathy Speed

 

Background

 

Your own blood contains growth factors that can promote healing in injuries of muscles, tendons and ligaments. These growth factors may reduce pain and disability and speed the recovery from injury. Autologous blood injections are a relatively new approach to the management of soft tissue injuries.

 

What will the procedure involve?

 

The skin over your injury will be cleaned. Then local anaesthetic will be injected with a fine needle into the area of your injury, in order to make the site numb.

 

A small amount of blood (about 2 ml) will be taken from one of your arms, in just the same way that it is taken for a blood test. This blood will then be injected into the site of your injury using a fine needle.  Afterwards, a plaster will be placed on the skin where the injection has been performed.

 

You will be given advice about rest and appropriate exercise to perform after the injection.

 

What are the possible side effects?

 

As with any procedure there can be side effects. There may be mild discomfort associated with having blood taken and having an injection.

 

Due to the injection there may be a very small risk of infection, but this is minimal and no greater than for any injection. Sterile precautions are taken throughout the procedure to prevent infection.

 

The injection may also cause a temporary flare of pain.

 

Please be sure to ask the doctor beforehand if you have any questions about the injection, and also to inform the doctor if any concerns arise after the procedure.

 

Ultrasound-guided autologous blood injection for tennis elbow.

.Connell DA, Ali KE,Ahmad M, Lambert S,Corbett S,Curtis MSkeletal Radiol. 2006 Jun;35(6):371-7. Epub 2006 Mar 22.

Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, H47 4Lp, UK, david.connell@rnoh.nhs.uk.

OBJECTIVE: To assess the efficacy of autologous blood injection under sonographic guidance for the treatment of lateral epicondylitis. DESIGN AND PATIENTS: Thirty-five patients (23 men, 12 women, mean age 40.9) with refractory lateral epicondylitis (mean symptom duration 13.8 months) underwent sonographic evaluation prior to dry-needling the tendon and injection with autologous blood. Patients were reviewed, and measures of Nirschl and Visual Analogue Scores (VAS) were taken pre-procedure and post-procedure, at 4 weeks and 6 months. RESULTS: Following autologous blood injections, significant reductions were reported for Nirschl scores, which decreased from a median (inter-quartile range) pre-procedure score of 6 (6-7), to 4 (2-5) at 4 weeks (p<0.001), and to 0 (0-1) at 6 months (p<0.001). Similarly, significant reductions were reported for VAS scores from a median (inter-quartile range) pre-procedure score of 9 (8-10), to 6 (3-8) at 4 weeks (p<0.001), and to 0 (0-1) at 6 months (p<0.001). Sonography demonstrated a reduction in the total number of interstitial cleft formations and anechoic foci; a significant reduction in tendon thickness from a mean (SD) of 5.15 mm (0.79) at baseline to 4.82 mm (0.62) at 6 months post-procedure (p<0.001) was observed. Hypoechoic change significantly reduced from a median (inter-quartile range) of 7 (6-7) at baseline to 2 (1-3) at 6 months post-procedure (p<0.001). Neovascularity also significantly decreased from a median (inter-quartile range) of 6 (4-7) at baseline to 1 (0-3) at 6 months post-procedure (p<0.001), although sonographic abnormality remained in many asymptomatic patients. CONCLUSIONS: Autologous blood injection is a primary technique for the treatment of lateral epicondylitis. Sonography can be used to guide injections and monitor changes to the common extensor origin.

 

And a study on rabbits!

 

The response of rabbit patellar tendons after autologous blood injection.

Taylor MA, Norman TL, Clovis NB, Blaha JD. Med Sci Sports Exerc. 2002 Jan;34(1):70-3.

Musculoskeletal Research Center, Department of Orthopedics West Virginia University, Morgantown, WV 26506-9196, USA.

PURPOSE: Blood is a rich source of growth factors that can stimulate fibrocyte migration and help induce neovascular ingrowth. These properties may be able to stimulate a healing response in chronic degeneration of a tendon (tendonosis). The purpose of this study was to assess the biomechanical and histological effects of autologous blood injection on animal tendons. METHODS: New Zealand white rabbit left side patellar tendons were injected with 0.15 cc of autologous blood. We then compared the mechanical properties and histology to the normal right patellar tendon at 6 and 12 wk. RESULTS: At 6 and 12 wk after the injection, there were no differences in the histology compared with normal tendon tissue, and there were no significant changes in tendon stiffness. Biomechanically, the tendons were not damaged at 6 wk after the injection. By 12 wk, tendons that were injected with blood were significantly (P < 0.014) stronger. CONCLUSION: We found that injecting blood directly into normal tendons appears safe. Further evaluation of this technique would appear indicated.