Platelet-rich plasma and corticosteroid injection in lateral epicondylitis: Who is great

Abstract

Elbow epicondylar tendinitis is a common problem that usually resolves with nonoperative treatments. When these measures fail, there is a role of Platelet-rich plasma (PRP) for tissue repair. The trial was conducted in Bangabandhu Sheikh Mujib Medical University Hospital during the period August 2016 to February 2017. One hundred patients with chronic lateral epicondylitis were randomly assigned to a leukocyte-enriched PRP group ( n = 51) or the corticosteroid group ( n = 49). Patients received either a corticosteroid injection or an autologous PRP injection through a peppering needling technique. Outcome was measured in terms of Visual Analog Scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH). Success was defined as a reduction of 25% on VAS or DASH scores without a re-intervention within 6 months. When baseline VAS and DASH scores were compared with the scores of 6 months follow-up, both groups significantly improving within this time (intention-to-treat principle). But the DASH scores of the corticosteroid group come back to baseline levels, while the PRP group is unchanged at the end of 6 months (as-treated principle). The PRP group shows better outcome than the corticosteroid group ( P < 0.0001). There were no complications shown in the use of PRP. Patients with chronic lateral epicondylitis treated with PRP reduces pain and increases function, exceeding the effect of corticosteroid injection.