Efficacy of Platelet-Rich Plasma in Tennis Elbow in Patients Presenting in a Public Sector Hospital: A Prospective Observational Study

Abstract

Background: Platelet rich plasma (PRP) is a supra-physiological concentrate of growth factor. It is biologically safe, minimally invasive and low cost injectable technique for tendinopathies. Evidence suggests that PRP contains bioactive protein and growth factor that promote regeneration. Aim of this study is to assess the efficacy of PRP in tennis elbow and to evaluate its impact on pain and functional outcomes.
 Methods: It was a prospective observational study in department of orthopedics surgery, Services Hospital Lahore from December 2017 to June 2019. Forty 40 patients with chronic tennis elbow lasting 4-6 months, both males and females with aged between 18-60 years were included. Thirty milliliters of patient's autologous blood was taken from median cubital vein and 6-7ml of platelet rich plasma was injected at the point of maximal tenderness at extensor carpi radialis brevis (ECRB) tendon. Patients were followed at 2 weeks, 6 weeks, 3 months and 6 months. Functional outcomes were assessed at each visit using Oxford Elbow Score, while visual analogue score (VAS) was used to assess pain.
 Results: Mean Pre-injection VAS was 8.0 ± 2.01 in all patients. At six months, VAS was 1.06 ±1.90 in 34 patients. In six (15%) patients, VAS did not improve. Pre-injection Oxford Elbow Functional score (OES) was 20.12 ± 4.08 (range:22.2-26.8). After 6 month of injection, among 34 patients, it improved to 72.12 ± 12.25 (range: 42.34-90.52)
 Conclusion: PRP is effective in terms of pain and improvement of function of elbow in patients with tennis elbow. It is cost effective, minimally invasive, simple and safe. Although literature shows some controversy of PRP in tendinopathies but still the regenerative medicine has opened a new window for restoration of tendinopathies