Efficacy of local injection of autologous platelet rich plasma in treatment of lateral epicondylitis

Abstract

Objective To investigate the effect of local injection of autologous platelet rich plasma in the treatment of lateral epicondylitis. Methods From January 2013 to January 2015, 60 patients with lateral epicondylitis undergent local injection therapy were randomly divided into two groups: PRP group (30 patients received autologous PRP)and glucocorticoid group(30 patients received prednisolone acetate and lidocaine). All the patients had the same accelerated rehabilitation protocol and were followed up in one, three, and 12 months. Evaluation consisted of inflammatory reaction, visual analogue scale(VAS), Mayo elbow performance score(MEPS)and disablities of the arm shoulder and hand(DASH)score. Independent samples t test was used to compared two groups, grade data used rank sum test. Overall differences in VAS , MEPS, DASH scores were analyzed by variance for repeated measurement data, differences at each time point were analyzed by independent samples t test. Results After the operation, no inflammatory reaction was in 28 cases of the PRP group and in 27 cases of the glucocorticoid group, mid inflammatory reaction in one case of PRP group and in two cases of glucocorticoid group, moderate inflammatory reaction in one case of PRP group and in one case of glucocorticoid group. In PRP group, the pretreatment, one month , three months and 12 months post-treatment VAS scores were (75±9), (64±8), (42±9), (21±9); DASH scores were (138±10), (113±10) , (82±10), (52±10) , MEPS scores were (25±4), (45±4), (63±4) , (82±4). In glucocorticoid group, the pretreatme, 1month, 3 months and 12 months post-treatment VAS scores were (74±9) , (53±9), (45±8), (55±9) , DASH scores were (133±11), (99±10), (85±10), (98±10), MEPS scores were (27±4), (54±4), (62±4), (47±5). Inflammatory reaction was not statistically significant different between the two groups (P>0.05). The total difference of VAS , DASH, MEPS score between the two groups were statistically significant(VAS F=15.98, P 0.05). Conclusions Antologous PRP and glucocorticoid local injection in the treatment of external humeral epicondylitis can alleviate pain, restore the function of elbow joint. Glucocorticoid may be better at the begining and then the effect will decline, whereas PRP can progressively improve effects without adverse effects, which is worthy of promotion in the clinic. Key words: Platelet-rich plasma; Tennis elbow; Glucocorticoids; Pain