Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis in a Double-Blind Randomized Controlled Trial
The Regenerative Clinic's view on this research
Mr Ali Noorani “In 2010 a study published by Peerbooms et al was published comparing the positive effect of platelet-rich plasma in lateral epicondylitis (tennis elbow). This was a double blind randomised control trial providing a level 1 evidence comparing platelet-rich plasma (PRP) with the effects corticosteroid injections with patients with chronic lateral epicondylitis. The study concluded that although the corticosteroid was initially slightly better than the PRP, in the long-term PRP treated patients did much better and progressively improved.A follow up study by the same group published in 2011 with the same patients with two years follow up. They concluded that those patients with treated with corticosteroid returned back to base line whereas those treated with PRP continued to improve and maintained this improvement at 2 years.They concluded that treatment of patients with chronic lateral epicondylitis (tennis elbow) with PRP reduces pain and increases function significantly, exceeding the effects of cortico steroid injections even after a follow up of two years.”
Purpose: To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis.
Study Design: Randomized controlled trial; Level of evidence, 1.
Patients: The trial was conducted in 2 teaching hospitals in the Netherlands. One hundred patients with chronic lateral epicondylitis were randomly assigned in the PRP group (n 5 51) or the corticosteroid group (n 5 49). A central computer system carried
out randomization and allocation to the trial group. Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering technique. The primary analysis included visual analog scores and DASH Outcome Measure scores (DASH: Disabilities of the Arm, Shoulder, and Hand).
Results: Successful treatment was defined as more than a 25% reduction in visual analog score or DASH score without a reintervention after 1 year. The results showed that, according to the visual analog scores, 24 of the 49 patients (49%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was significantly different (P \ .001). Furthermore, according to the DASH scores, 25 of the 49 patients (51%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was also significantly different (P 5 .005). The corticosteroid group was better initially and then declined, whereas the PRP group progressively improved.
Conclusion: Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateral epicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.