Me and my operation: Surgeons used my own blood and a tumbledryer to cure my tennis elbow

Tennis elbow affects around 300,000 people a year in the UK, leaving many in chronic pain. Financial adviser Tito Soso, a 43-year-old father-of-two from London, tells PAT HAGAN how a new ten-minute treatment using a jab made from his own blood saw him back on the courts within weeks.


Tito Soso

'Back on the court within weeks': Tito Soso said he is 'ecstatic' with the results of his treatment

Since I was a child, I've loved tennis and I played competitively. But life has a habit of getting in the way, and it's only in the past two or three years that I've had a chance to play again.

After nearly two decades off the court, I was back playing two or three times a week and thoroughly enjoying myself.

The coaches at my club advised me to change the way I held the racquet in order to inject more power and 'whip' into my serve and forehand. This meant holding it a little further down the grip than I would normally, to give my wrist more flexibility during the serve.

I noticed an improvement straight away  -  my serve was faster  -  and a few weeks later I practised the technique on holiday in Greece with my family, where I played every day, sometimes up to four hours at a time.

But within days of returning home, I had pain in my elbow and the top of my forearm. (I knew it was tennis elbow because I'd had it once as a child.)

It was a constant niggling pain and certain activities caused it to flare up. I fly a lot on business  -  sometimes several times a week  -  and it was always painful retrieving my bag from the overhead locker.

The pain got so bad it woke me at night. Painkillers helped, but I knew they weren't addressing the underlying problem, so I decided to stop playing for a couple of months to allow the inflammation to go down.

It was terribly frustrating, especially as I'd been making progress in my game. I was desperate to get back on the court, but when I did, two months later, the pain returned.

I wasn't keen on what I thought would be the next option  -  a steroid injection into the elbow to bring down the swelling. I knew the injections are not always successful and can be quite painful.

A physio, treating me for back and shoulder problems at the time, suggested that I try a new treatment called platelet-rich plasma therapy being offered at the London orthopaedic Clinic.

Doctors took a small sample of my blood  -  roughly two tablespoons' worth  -  and spun it in a special machine, a bit like a tumble dryer, to separate out the platelets, tiny cells in the blood.

Platelets are a good source of chemicals, called growth factors, that have a healing effect on damaged tendons and even stimulate the growth of new ones. 

elbow joint

Painful: Tennis elbow affects around 300,000 people a year in the UK

'Spinning' my blood allowed the platelets to be concentrated into about half-a-teaspoon of plasma, the straw-coloured liquid that makes up 55 per cent of our blood. This was then injected into my elbow.

The procedure took about ten minutes and was no more uncomfortable than having a jab. I had a warm sensation in my elbow which wore off after a few days. It was repeated a week later and again a week after that, and I was given stretching exercises to help the healing process. A few weeks after my final injection in November, I picked up my racquet again. I played rather gingerly at first, but pretty soon I was able to hit the ball as hard as I used to.

I don't wake up in pain any more, and can pick up my two daughters  -  aged four and eight  -  with ease. Last weekend I played tennis for four hours and felt fine afterwards. I'm ecstatic with the outcome.


Dr Ralph Rogers, consultant in sports and musculoskeletal medicine at the London Orthopaedic Clinic, says:

Tennis elbow, or lateral epicondylitis, develops when tendons  -  tough cords of tissue that connect muscle to your bones  -  become damaged, often through overuse. This damage causes inflammation, which can lead to pain. sports such as tennis, squash and badminton can trigger the problem, but it is commonly caused by any type of repetitive movements, such as using scissors or a screwdriver.

The main symptom is pain in the outer side of the elbow. The condition can be so crippling that it can be difficult to use the damaged arm for everyday activities such as driving.

Even in mild cases, the pain can last two to three weeks and can spread to the upper and lower arm.

In some cases, the body tries to compensate for the weakness in the elbow by putting pressure on other areas, such as the shoulder and neck. These, too, gradually become stiffer and more painful.

Treatments include painkillers and anti-inflammatories. But many find the pain returns once they resume the activity that originally caused it.

The other option is to inject the steroid cortisone into the elbow to reduce the swelling in the tendons. This can take a couple of weeks to work, and some people need two to three jabs before it is effective.

But steroid injections can be very hit and miss. A study in the British Medical Journal in 2006 showed that they were no more effective than gentle exercises and physiotherapy.

Platelet-rich plasma therapy has been used in parts of Europe and the U.S. for many years but it's only just starting to catch on in Britain. The idea is that we 'harvest' large numbers of platelets from the patient's blood and inject them into the damaged tissue.

Platelets have a high content of 'growth factors'  -  proteins that help injured tissue heal. Certain growth factors in platelets are known to stimulate repair to tendons damaged in tennis elbow. They do this by sending out signals for other cells to 'rush' to the affected area. one such cell type is fibroblasts. These are immature cells that can develop into new tendon or ligaments. In order for that to happen, we need to concentrate a high number of platelets into a small amount of plasma, the liquid component in blood in which blood cells are suspended.

To do this, we took roughly two tablespoons of blood from Tito's arm and spun it in a machine for about five minutes. This allowed the heavier blood cells to sink to the bottom of the cylinder, while the lighter plasma  -  containing a much higher concentration of platelets  -  rose to the top.

Using an ultra-fine needle, I injected the plasma into two sites, about one centimetre apart, on Tito's elbow. he had three injections over three weeks, after which it took another couple of weeks to work.

I can't say for certain that Tito will not need any more treatment in the future, but the results from other countries suggest it is a permanent solution for many patients. research shows that two years after treatment, more than 90 per cent of patients are still pain-free.

One U.S. study showed that within four weeks of receiving a single injection, patients reported pain had dropped by nearly 50 per cent.

  • Platelet-rich plasma therapy costs £900-£1,200 at the London Orthopaedic Clinic,

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