A comparative effectiveness of activated platelet-rich plasma versus autologous whole blood in the management of lateral epicondylitis: A randomized clinical trial of functional outcome

Abstract

Background: Lateral epicondylitis (tennis elbow), a familiar term used to describe myriad of symptoms around the lateral aspect of elbow mainly due to intra-tendinous degeneration assosciated with ageing, repetitive movement and vascular compromise. Activated platelet-rich plama (PRP) and Autologous whole blood (AWB) injections represent new therapeutic options for chronic tendinopathies including tennis elbow. But from the literature, no firm conclusions can be drawn about the effectiveness of PRP versus AWB or the superiority of one method over the other. Our aim of study was to compare the effectiveness and functional outcome of both modalities. Methods: 50 patients with chronic lateral epicondylitis (>3 months) with restricted ROM were included in this study and randomized into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP (4.8 times of plasma) with 1ml of calcium chloride as activator and group 2 with 2 mL of AWB injection followed by elbow-strap, stretching and strengthening exercises for both groups. Pain and functional outcomes were assessed using visual analogue scale (VAS) and NIRSCHL staging (NS) at 0, 4, 8 weeks, 6 months and 12 months. Results: Pain variables including VAS and Nirschl scores improved significantly in both groups at short and intermediate duration but on long term follow up intervals PRP showed better improvement between groups regarding pain severity, functional improvement and recurrence rates. Conclusion: Both PRP and AWB injections are effective to treat chronic lateral epicondylitis but for longer duration the efficacy persisted with PRP seems to be superior than AWB.