Autologous platelet-rich plasma versus corticosteroid in the management of elbow epicondylitis: A randomized study

Abstract

Introduction:Elbow epicondylar tendinitis is a common problem for patients whose activities require strong gripping or repetitive wrist movements in the day-to-day activities of life. Histologic specimens from chronic cases confirm that tendinitis is not an acute inflammatory condition but rather a failure of the normal tendon repair mechanism associated with angiofibroblastic degeneration. Tendon regeneration may be improved by injecting autologous growth factors obtained from the patient's own blood. Autologous growth factors can be injected with autologous whole blood or platelet-rich plasma (PRP).Materials and Methods:A randomized study with 83 patients was done. The study population comprised two groups. Group A (n = 50) treated with local steroid injection and Group B (n = 33) treated with autologous PRP. Patients were allocated randomly using computer-generated random number table. The base-line evaluation was done using visual analog score (VAS) and modified Mayo performance index for elbow (MAYO). Re-evaluation was after 1, 2, and 6 months of the procedure. Statistical analysis was done using independent t-test.Results:Six months after treatment with PRP, patient's with elbow epicondylitis had a significant improvement in their VAS (P < 0.05) and MAYO (P < 0.05) in contrast to steroid, whereas no statistical difference was found between the two groups at 1 and 2 months after intervention.Conclusion:Treatment of patients with epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection.

Platelet‐Rich Plasma Vs Autologous Blood Vs Corticosteroid Injections in the Treatment of Lateral Epicondylitis: A Systematic Review, Pairwise and Network Meta‐Analysis of Randomized Controlled Trials

“…At this stage, 87 studies that did not meet the inclusion criteria were excluded. Twenty eligible RCTs were included in our network meta‐analysis (Figure ). In 13 PRP trials, the PRP preparation contained a high concentration of leukocytes in three trials and was relatively pure with deleted leukocytes in 10 trials .…”

“…Twenty eligible RCTs were included in our network meta‐analysis (Figure ). In 13 PRP trials, the PRP preparation contained a high concentration of leukocytes in three trials and was relatively pure with deleted leukocytes in 10 trials . Most studies measured outcomes at more than 2 months; only five studies measured outcomes at 3 weeks to 2 months.…”

“…In 13 PRP trials, the PRP preparation contained a high concentration of leukocytes in three trials and was relatively pure with deleted leukocytes in 10 trials . Most studies measured outcomes at more than 2 months; only five studies measured outcomes at 3 weeks to 2 months. The sample size of each treatment group in the trial, average age, and symptom duration varied from 9 to 80, 35.3 to 54 year, and <1 to 35.6 month, respectively.…”

Efficacy, safety and tolerability of autologous platelet rich plasma injection in the treatment of lateral epicondylitis

“…The α and β risks (respectively 5% and 20%) and the variability of the variables (mean VAS steroid=4.69 and mean VAS PR=0.69, SD=4.6) were taken into account, and a minimum number of 26 participants per group was thus determined. 2 Considering the dropouts, actual sample size taken in each group was 30 patients.…”

“…1 It is commonly found in patients whose activities require strong gripping or repetitive wrist movements in the day-to-day activities of life. 2 The most commonly involved structure is the Extensor Carpe Radialis Brevis (ECRB) which attaches to the lateral epicondyle of the humerus. The other tendons which join the ECRB on the lateral epicondyle are extensor carpe ulnaris, extensor digiti mini and extensor digitorum.…”