Platelet-Rich Plasma versus Corticosteroid Injection for Recalcitrant Lateral Epicondylitis: Clinical and Ultrasonographic Evaluation

Abstract

PRP appeared to enable biological healing of the lesion, whereas CS appeared to provide short-term, symptomatic relief but resulted in tendon degeneration.

A Systematic Review to Compare Three Injection Modalities in the Management of Pain and Function for Patients with Chronic Lateral Epicondylalgia

“…Furthermore, PRP demonstrated better outcomes at 2 years (P< 0.0001). In another trial in 2013 [11][12][13], CSI resulted in better outcomes at 1 month (P<0.003), with no difference between PRP and CSI groups at 3 months (P = 0.717). In the study in 2015 [12], PRP had better outcomes in comparison with CSI at 6 months (P<0.001).…”

“…A peppering technique was used in all of the three trials which applied PRP and CSI, but two trials [11,12] did not specify the number of penetrations performed in the CSI arms. Most researchers in these four trials performed a single skin entry with 5 to 7 peppering penetrations.…”

“…The differences in the study conducted in 2015 from the other two trials are that: they collected 20 ml from the participants of PRP treatment arm, used acid citrate as an anticoagulant, the speed of the centrifuge was set at 1500, 2 ml was injected, and there was no mention of the use of local anaesthetic [12].…”

Is there a treatment protocol in which platelet-rich plasma is effective?

“…[37][38][39][40] When the studies in which PRP was obtained from autologous blood in clinics were considered, it was found that it was prepared from 10 to 20 min. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Nevertheless, it takes time to apply it to cases, which makes its bioactive and effective treatment results controversy.…”

“…6 For this very reason, it is applied in all fields of medicine including orthopaedic surgery in tissue damage treatments. 7,8 PRP's use has been increasing in many cases such as primarily osteoarthritis, 9 proximal hamstring, 10 Achilles, 11 patellar tendinopathies, 12 talar osteochondral lesions, 13 rotator cuff damage repair, 14 lateral epicondylitis treatment, 15 relieving pains following arthroplasty 8 and contributing to bone healing of tibia in distraction osteogenesis. 8 However, as there are contradictory results reported in some cases in literature where PRP was applied, there are some questions regarding the efficiency of PRP treatment.…”