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VOLUME 3 , ISSUE 1 ( January-March, 2017 ) > List of Articles

RESEARCH ARTICLE

Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis

KM Gopinath, Madhuram Chowdry, BNR Kumar, TR Kanmani

DOI: 10.5005/jp-journals-10045-0045

License: NA

Published Online: 01-12-2017

Copyright Statement:  NA


Abstract

Introduction

Tennis elbow is a common condition with unpromising several modalities of treatment. Many of these are not aimed at treating the disease process. Platelet-rich plasma (PRP) contains biological healing factors and shows promising results in tendinopathies.

In this study, our aim was to evaluate the efficacy of autologous PRP vs steroid injection in the treatment of chronic recalcitrant lateral epicondylitis.

Materials and methods

A prospective randomized control trial was conducted in our tertiary care hospital. Sixty patients with chronic lateral humeral epicondylitis, not responding to oral medications, tennis elbow belt, and physiotherapy, aged between 18 and 60 years were included in the study. Patients were randomized into PRP or steroid injection group based on a computer-generated block randomization chart. All patients had a baseline assessment including visual analog pain scores, Disability assessment of Shoulder and Hand score (DASH), and Nirschl (Injury, Prevention, Cure and Care – Nirschl Pain Phase Scale of Athletic Overuse Injuries) scores, and the same was repeated at 2 weeks, 6 weeks, 3 months, and 6 months postintervention.

Results

Steroid treatment shows better outcome in short-term (p < 0.001) and PRP shows better outcome in long-term (p < 0.001) follow-up. All three scores – visual analog score (VAS), DASH, Nirschl – showed significant linear improvement with PRP treatment, whereas with steroid injection initially there was significant improvement up to 3 months and later recurrence of symptoms. No complications were noted with PRP injection.

Conclusion

Use of autologous PRP injections for the management of lateral epicondylitis has better long-term outcomes compared with steroid injection in terms of VAS, DASH, and Nirschl scores. Also in our trial we had no recurrence of symptoms in the PRP group, whereas pain recurred in six patients in steroid group and was treated successfully with PRP.

How to cite this article

Chowdry M, Gopinath KM, Kumar BNR, Kanmani TR. Comparative Study of Efficacy between Platelet-rich Plasma vs Corticosteroid Injection in the Treatment of Lateral Epicondylitis. J Med Sci 2017;3(1):1-5.


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  1. The pathology and treatment of tennis elbow. J Bone and Joint Surg 1936 Oct;18(4:)921-940.
  2. Can platelet rich plasma enhance tendon repair: a cell culture study. Am J Sports Med 2008 Jun;36(6:)1171-1178.
  3. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 2005 Mar;23(2:)281-286.
  4. The clinical use and immunologic impact of thrombin in surgery. Semin Thromb Hemost 2006 Feb;32(1:)98-110.
  5. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998 Jun;85(6:)638-646.
  6. The roles of growth factors in tendon and ligament healing. Sports Med 2003 Apr 1; 33(5):381-394.
  7. The effect of thrombin on ACL fibroblast interactions with collagen hydrogels. J Orthop Res 2006 Mar;24(3:)508-515.
  8. Elbow tendinosis/tennis elbow. Clin Sports Med 1992 Oct;11(4:)851-870.
  9. Tennis elbow. The surgical treatment of lateral epicondylitis. J Bone Joint Surg Am. 1979 Sep 1; 61(6):832-839.
  10. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 2010 Feb;38(2:)255-262.
  11. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum 2009 May 15;61(5):623-632.
  12. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med 2008 Dec 1;1(3-4):165–174.
  13. Modulation of wound response and soft tissue ingrowth in synthetic and allogeneic implants with platelet concentrate. Arch Facial Plast Surg 2005 May-Jun 1;7(3):163-169.
  14. What do we mean by the term “inflammation”? A contemporary basic science update for sports medicine. Br J Sports Med 2004 Jun 1; 38(3):372-380.
  15. Treatment of lateral epicondylitis with botulinum toxin: a randomized, double-blind, placebo-controlled trial. Ann Intern Med 2005 Dec 6;143(11):793-797.
  16. Current opinion about using the plateletrich gel in orthopaedics and trauma surgery. Ortop Traumatol Rehabil 2006 Dec;9(3:)227-238.
  17. Blood flow and oxygenation in peritendinous tissue and calf muscle during dynamic exercise in humans. J Physiol 2000 Apr 1;524(Pt 1):305–313.
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