Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

Abstract

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P > 0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P < 0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

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 .…”

Extracellular Vesicles from Platelet-Rich Plasma as Conveyors of Regeneration Potential in Orthopedics

“…PRP use has hitherto been investigated in the treatment of lateral epicondylitis [6,7], knee osteoarthritis [8], hip osteoarthritis [9] patellar and Achilles tendinopathy [10][11][12], muscle injury [13] and anterior cruciate ligament injury [14]. Some studies concluded with promising outcomes that will hopefully set the new milestones of treatment options.…”

“…The effects of PRP treatment of lateral epicondylitis were compared with an autologous whole blood [6] and corticosteroid injections [7]: the analysis of 20 patients treated with PRP and 20 patients treated with whole blood for lateral epicondylitis showed that pain assessed by Visual Analog Scale (VAS), Mayo Elbow Performance Index, and pressure pain threshold (PPT) at 0, 4 and 8 weeks improved significantly in both populations. However, the authors indicated that 8 weeks after the treatment only the PRP group showed statistically significant improvement (P<0.05) [6]. Another analysis of lateral epicondylitis treatment considered 51 patients treated with PRP and 49 patients treated with corticosteroid injections [7].…”

Efficacy and Safety of Autologous Blood Products Compared With Corticosteroid Injections in the Treatment of Lateral Epicondylitis: A Meta‐Analysis of Randomized Controlled Trials

“…The long‐lasting effects of ABPs on pain relief and functional restoration for LE have been observed in many clinical studies. Moreover, they are safe, readily available, and have a low risk of adverse effects [12‐14].…”