Platelet-Rich Plasma for Elbow Pathologies: a Descriptive Review of Current Literature

Abstract

Purpose of ReviewPlatelet-rich plasma is used in many orthopedic pathologies such as tendinopathies and ligament injuries. The clinical results reported in the scientific literature are, however, confusing. The aim of this manuscript is to provide a narrative literature review regarding the role of PRP in the most common elbow soft tissue pathologies.Recent FindingsThe response to PRP seems to be favorable when compared to steroid injection for pain management and for patient-reported outcomes in lateral epicondylitis. PRP injection does not seem to have the potential complications associated with a steroid injection such as skin atrophy, discoloration, and secondary tendon tears. Only a few manuscripts comparing the results of PRP treatment with either extracorporeal shockwave (ESW), dry needling, or even surgical treatments in lateral epicondylitis exist. The use of PRP in other elbow pathologies such as golfer’s elbow, ulnar collateral ligament injury, and distal biceps and triceps pathology is examined in few studies, with unclear recommendations.SummaryRegarding elbow pathologies, PRP injections in tennis elbow seems to be the best-studied intervention. A major limitation in these studies is the significant heterogeneity in the methods used for preparing PRP, for example employing leukocyte-rich, leukocyte-poor preparations, PRP with or without activation, which makes the results of the studies difficult to compare. Results of this review show that more studies on larger cohorts, with comparable formulations, and with longer follow-up are required to give optimal suggestions concerning the use of PRP in elbow pathologies.

Efficacy of different platelet‐rich plasma injections in the treatment of mild‐moderate knee osteoarthritis: A systematic review and meta‐analysis

“…The benefits of PRP have been reported to reduce proinflammatory mediators and raise the effect of anti‐inflammatory 10 . Thus, intra‐articular PRP injection has been adopted to treat musculoskeletal diseases 10‐13 …”

In Vitro Effect of Triamcinolone and Platelet-rich Plasma on Lateral Epicondylitis-derived Cells

“…However, according to the natural history of LE, it can evolutes with spontaneous improvement in six months. Another di cult that we found was the lack of standardization for the PRP production, which makes it di cult to compare with studies in the literature, as PRPs are very heterogeneous and qualitatively very different, with no strong evidence regarding the ideal preparation, dosage and e cacy [31,33,34].…”

New Frontiers or the Treatment of Interstitial Cystitis/Bladder Pain Syndrome - Focused on Stem Cells, Platelet-Rich Plasma, and Low-Energy Shock Wave

“…PRP is a natural source of signaling molecules, and upon activation of the platelets in PRP, the P-granules are degranulated, releasing growth factors and cytokines that modify the pericellular microenvironment. Some of the most important growth factors released by platelets in PRP are vascular endothelial growth factor, fibroblast growth factor, EGF, hepatocyte growth factor, insulin-like factor 1 and 2, matrix metalloproteinase (MMP) 2 and 9, and interleukin (IL)-8 [48,50,51]. PRP promotes 4 main actions (proliferation, migration, cell differentiation, and angiogenesis) in the local environment where it is administered.…”