Summary

purpose of this study is to compare the longterm functional outcome of lateral epicondylitis treated with PRP and steroid injection.

Abstract

Background

Autologous injection of platelet rich plasma (PRP) stimulates healing process in degenerated tendons. In recent times Steroid injection and PRP are used extensively for treatment of lateral epicondylitis. The purpose of this study is to compare the longterm functional outcome of lateral epicondylitis treated with PRP and steroid injection.

Methodology

Clinically diagnosed lateral epicondylitis patients who failed conservative medical therapy were included in the study. Patients with previous surgery, vascular disease, neuropathy related to elbow pain were excluded from study. In this prospective double-blind study 140 patients included were divided randomly into two groups. Patients in group-A received PRP injection and in group-B received steroid injection. steroid group (n=70) and PRP group (n=63). Data were collected before procedure, at 4, 8, 12 weeks, 1 year and 2 years after procedure. The main outcome measures were visual analogue score, Mayo elbow performance score, DASH score and hand grip strength. Among 70 patients in group B, 7 patients were missed for followup, hence not included in final outcome.

Results

Successful treatment was defined as more than a 25% reduction in visual analogue score or DASH score and more than 75 score in Mayo elbow performance score. We observed that 35 of the 70 patients (50%) in corticosteroid group and 47 of the 63 patients (75%) in PRP group were successful, which was significantly different (p<.001), according to DASH score 37 of the 70 patients (53%) and 47 of the 63 patients (75%) in the PRP group were successful which was also significantly different (P <.005), Mayo elbow performance score was successful in 36 of the 70 patients (51%) in corticosteroid group and 49 of the 63 patients (78%) in PRP group. The improvement in hand grip strength of hand from 24.7kg (mean) 26kg in corticosteroid group and 23.5kg (mean) to 32.9kg (mean) in PRP group.

Conclusion

PRP injection for chronic lateral epicondylitis reduces pain, improve functionality and hand grip strength when compared to steroid injection and beneficial effects last long.