Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial

Abstract

BackgroundLateral humeral epicondylitis, or ‘tennis elbow’, is a common condition with a variety of treatment options. Platelet-rich plasma (PRP) and Autologous Whole Blood (AWB) represent new therapeutic options for chronic tendinopathies including tennis elbow. The aim of the present study was to compare the long term effects of PRP versus autologous whole blood local injection in patients with chronic tennis elbow.MethodsSeventy six patients with chronic lateral humeral epicondylitis with duration of symptoms more than 3 months were included in this study and randomized into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous leukocyte rich PRP (4.8 times of plasma) and group 2 with 2 mL of AWB. Tennis elbow strap, stretching and strengthening exercises were administered for both groups. Pain and functional improvements were assessed using visual analogue scale (VAS), Mayo score (modified Mayo Clinic performance index for the elbow) and pressure pain threshold (PPT) at 0, 4, 8 weeks and 6 and 12 months.ResultsAll pain variables including VAS, PPT and Mayo scores improved significantly in both groups at each follow up intervals compared to baseline. No statistically significant difference was noted between groups regarding pain, functional scores and treatment success rates in all follow up examinations (P >0/05).ConclusionPRP and autologous whole blood injections are both effective methods to treat chronic lateral epicondylitis and their efficacy persisted during long term follow up. PRP was not superior to AWB in long term follow up.

A comparative effectiveness of activated platelet-rich plasma versus autologous whole blood in the management of lateral epicondylitis: A randomized clinical trial of functional outcome

“…The mean age encountered was 42.6 years and 41.1. Seyed Ahmad Raeissadat et al (2014) in his study observed the same [13] . Contrary to other studies (Hay et al [14] , Edwards and Calandruccio) [11] more number of female patients in our current study may be due more involvement with household work, a relevant etiology for the initiation of the disease.…”

“…Contrary to other studies (Hay et al [14] , Edwards and Calandruccio) [11] more number of female patients in our current study may be due more involvement with household work, a relevant etiology for the initiation of the disease. Seyed Ahmad Raeissadat et al (2014) in his study also observed females are more involved [13] . In almost all the studies (Verhaar et al [15] Seyed Ahmad Raeissadat et al (2014), Edwards and Calandruccio) [11] it was found that the participants had their dominant side affected more as compared to their non-dominant side.The mean duration of the condition in all 50 patients suffering from lateral epicondylitis in both groups was 13.4 weeks were comparable with similar results as in his study by Chetan et al (2009) [16] .…”

“…Seyed Ahmad Raeissadat et al (2014) in his study also observed females are more involved [13] . In almost all the studies (Verhaar et al [15] Seyed Ahmad Raeissadat et al (2014), Edwards and Calandruccio) [11] it was found that the participants had their dominant side affected more as compared to their non-dominant side.The mean duration of the condition in all 50 patients suffering from lateral epicondylitis in both groups was 13.4 weeks were comparable with similar results as in his study by Chetan et al (2009) [16] . In our study more non manual workers were involved because more number of female patients were there in household work.…”

A Systematic Review to Compare Three Injection Modalities in the Management of Pain and Function for Patients with Chronic Lateral Epicondylalgia

“…Furthermore, in another trial in 2011 [13], PRP resulted in better outcomes at 6 weeks (P˂0.05), but no significant differences at 3 or 6 months (P = 0.32). However, the trial in 2014 reported no significant differences between ABI and PRP at 52 weeks (P = 0.662) [14,15].…”

Platelet-Rich Plasma Therapies in Lateral Epicondylitis: Are we Asking the Right Questions?

“…Research focused on the efficacy of autologous blood against control interventions is sparse and of lower quality. However, PRP has not been definitively proven to be more efficacious in the treatment of lateral epicondylitis than autologous blood [15,19,31,32]. Three systematic reviews comparing the modalities have concluded that the evidence available is insufficient to justify the use of PRP over autologous blood [17,30,33].…”