Abstract
Background: Painful elbow joint over the lateral epicondyle especially with resisted wrist extension are common signs of lateral epicondyle tendinopathy, also called tennis elbow.
 Objective: To evaluate the clinical outcome of local platelet rich plasma (PRP) injection in patients with chronic tennis elbow compared with a steroid (Depomedrol 40 mg) injection.
 Methods: A total of 88 patients with chronic tennis elbow were treated at Al-Kindy Teaching Hospital and private clinics. All patients had chronic pain for about 24 weeks or more and had failed first line treatment. The patients dividing into two groups, Group A injected with PRP (n = 44), and group B injected with depomedrol 40 mg (n = 44). A good clinical result was demarcated as 25% or more progress on the visual analog scale for pain. All patients followed for 6 months in both group for clinical successful result.
 Results: At three months (n = 44), in group A reported a perfection of 58.2% in their pain scores while 49.3% in the group B (N = 44). At 6 months follow up, the group A informed a perfection of 74.3% in their pain scores while 58.4 % in the group B. The local elbow tenderness recording at three months was 37.4% in the group A, while in the group B was 48.4%. At six months, 16.1% versus 30.2% recounted major elbow tenderness (P = .009) in groups (A and B) respectively.
 The clinical improvement rates at three months revealed no changes between both groups while it showed more significant clinically changes in group A ( 87.1%) than in group B (70.1 %) with P value = 0.008 after six months follow up.
 Conclusion: No important changes were found at 3 months in both groups, but at 6months, clinical significant perfections in patients treated with PRP group (group A)
Highlights
Tennis elbow is chronic lateral epicondylar tendinopathy, patient complaining of pain and tenderness over the lateral epicondyle, due to minor tear in the extensor carpi radialis brevis muscle with subsequent fibroblastic dysplasia [1] or due to neurogenic causes [2,3] or recently due to vascular response abnormality in the muscle [4]
A prospective study conducted in Al-Kindy Teaching Hospital and private clinics consisting of 88 patients,between 18 and 50 years old, with chronic lateral epicondylitis dividing randomly into two groups: group A, 44 patients treated with platelet rich plasma (PRP) and group B, 44 patients with local steroid injection
Our results demonstrated no significant differences regarding the improvement in the clinical pain score in both groups in follow up period one, two, and three months
Summary
Tennis elbow is chronic lateral epicondylar tendinopathy, patient complaining of pain and tenderness over the lateral epicondyle, due to minor tear in the extensor carpi radialis brevis muscle with subsequent fibroblastic dysplasia [1] or due to neurogenic causes [2,3] or recently due to vascular response abnormality in the muscle [4]. The first line includes activity reduction, non-steroidal antiinflammatory drugs, physiotherapy and rest by bracing When these measure fail second line treatment by steroid injection, plateletrich plasma (PRP) injections, and lastly surgery when these measures fail as third line which account about 10-15 % of cases. This include debridement, open or arthroscopically and tendon release with 85% success rate [6]. Objective: To evaluate the clinical outcome of local platelet rich plasma (PRP) injection in patients with chronic tennis elbow compared with a steroid (Depomedrol 40 mg) injection. Conclusion: No important changes were found at 3 months in both groups, but at 6months, clinical significant perfections in patients treated with PRP group (group A) Keywords: platelet-rich plasma, steroid, tennis elbow
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