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.
Highlights
Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow
Given the inherent nature of the tendon, new treatment options including platelets rich plasma (PRP), autologous blood, and prolotherapy are aimed at inducing inflammation rather than suppressing it [7,8,9]
All patients with clinical signs and symptoms of chronic lateral epicondylitis during May 2011– May 2012 referring to the physical medicine and rehabilitation clinic of Shahid Modarres Hospital which is a general educational hospital were evaluated to enter this randomized, single blind study
Summary
Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. Epicondylitis was initially believed to be an inflammatory process but in 1979, it was described as the disorganization of normal collagen architecture by invading fibroblasts in association with an immature vascular reparative response, which termed “angiofibroblastic hyperplasia” [1, 2] It causes pain and functional impairment in daily activities [2, 3]. The effectiveness of oral nonsteroidal anti-inflammatory agents, topical and injectable medications including corticosteroids and botulinum toxins, splinting, physical therapy, and iontophoresis has been evaluated in many studies [4] These traditional therapies do not alter the tendon’s inherent poor healing properties secondary to poor vascularization [5, 6]. PRP is quite a new treatment used for chronic tendinitis [4]. platelet rich plasma is defined as
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