What do you do if you have suffered a severe tendon injury such as tennis elbow? What are your options for recovery? Well, at present they are limited and typically only treat the symptoms of the damage or irritation caused by the affected tendon, they don’t enable regeneration of the tendon.
Normally tendons require weeks of rest in order to begin the healing process, and in 80% of cases the tennis elbow injury will settle down on its own accord, treatment is a combination of rest, NSAIDs and physiotherapy.
But for those patients suffering with chronic grade 3 lateral epicondylitis (tennis elbow) tendon injuries, the healing process can involve steroidal and non-steroidal injections and surgery, and in severe cases, healing may never occur.
The overuse of tendons in the forearm from repetitive movements (such as using a computer, lifting heavy objects or repetitive vibrations, for example) can put so much strain on the tendons in the elbow near the attachment on the humerus, that it begins a degenerative process, from which there has been no recovery.
Current treatment options for tennis elbow
- Rest – rest is recommended to help relieve pain and control inflaming the area further.
- NSAIDS – NSAIDS can be prescribed to reduce inflammation and combined with the application of ice onto the affected site, can work in tandem to decrease inflammation and reduce swelling. These typically offer short term pain relief (3-4 weeks).
- Physical therapy – there are many different types of physical therapy that can be beneficial to treating tennis elbow, and they all have the same aim – to reduce pain and improve function in the affected area.
- Brace – the wearing of an elbow counter force brace for some patients can prove beneficial as it mimics the role of a secondary muscle attachment site, helping to relieve tension on the affected tendon.
- Corticosteroid injections – these injections should be given early to maximise their beneficial effect, typically during the first 24-48 hours. Following that they should be repeated after a couple of weeks rest, but they should not be given more than two times. These typically offer short term pain relief (6 weeks)
- Surgical treatment – usually the last option to treat epicondylitis lateralis if all other non-invasive therapies have proved ineffective. Surgical procedures for treating tennis elbow typically involve removing any diseased muscle and reattaching the healthy, remaining muscle, back on to the bone. This surgery is usually open surgery, performed in an outpatient surgery, and involves making an incision over the elbow joint.
Tendoncel is a late stage allogeneic regenerative medicine, meaning it is designed to be ‘off the shelf’. This investigational topical gel has been shown capable of regenerating injured tendons near to the surface of the skin.
Following positive results from a Phase 2 testing trial, it could provide the safe and efficacious topical regenerative therapy that patients suffering with tennis elbow have been looking for. A Phase 3 trial is currently underway, following on from the successful European Phase 2 trial.
How does Tendoncel work?
Tendoncel is an investigational topical gel containing platelet lysate, which can be applied directly to the site of the injury i.e. the skin on the elbow. It contains a combination of growth factors including a substance which promotes regrowth of cells, enabling the tendon to repair and heal itself.
The Tendoncel Phase 2 clinical trial in patients with severe tennis elbow (chronic grade 3 lateral epicondylitis) showed significant improvements in their elbow pain, and if licensed in the UK could be a non-invasive treatment that negates the need for surgery.