Paper # 174: PRP or Steroids In Lateral Epicondylitis? RCT with Two Year Follow Up

Abstract

Platelet rich plasma in lateral apicondylitis safe and effective: the two year results. Platelet Rich Plasma (PRP) has shown to be a general stimulation for repair. To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis. A double blind randomized controlled trial with a two-year follow-up between May 2006 and January 2008. The trial was conducted in two teaching hospitals in The THE NETHERLANDS. 100 patients with chronic lateral epicondylitis were randomly assigned in the PRP group (n=51) or in the corticosteroid group (n=49). Randomization and allocation to the trial group were carried out by a central computer system. Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering needling technique. The primary analysis included VAS and DASH scores. Successful treatment was defined as more than a 25% reduction in VAS or DASH score without a reintervention after 2 years. The results resembled the results after 1 year follow up (published in AJSM 2010) but the 51 % success in the corticosteroid group dropped to 35% and the 73 % success in the PRP group increased to 80%. These figures were significantly different from each other and from baseline measurements (p<0.001). Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection, not only in the 6 monts and 1 year results, but also in the 2 year follow up, making PRP as a treatment more cost effective. After two years again no harmful effects were observed. Trial registration: ClinicalTrials.gov. Identifier: 2007-004947-31. http://www.clinicaltrials.gov