PRP versus steroids in a deadlock for efficacy: long-term stability versus short-term intensity—results from a randomised trial

Gupta, Prateek K.; Acharya, Ashis; Khanna, Varun; Khillan, Kamini; Sambandam, Senthil

doi:10.1007/s12306-019-00619-w

Cited by 23 publications

(15 citation statements)

References 23 publications

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“…PRP is a relatively recent treatment, with high cure rates [13,21]. However, the response to PRP occurs only after the sixth month of application, the cost is higher than triamcinolone due to processing [13,22] and it requires a -80 o C freezer for storage, if not immediately used [18].…”

Section: Discussionmentioning

confidence: 99%

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

Viveiros

Silva

et al. 2021

Preprint

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Background: Lateral epicondylitis (LE) is a common musculoskeletal condition. However, the treatment of LE is still controversial. The present study evaluated the production of inflammatory cytokines by lateral epicondylitis-derived cells and compared the anti-inflammatory effect of triamcinolone acetonide with platelet-rich plasma (PRP) on their production in cell culture.Methods: Third passage cells from primary cultures of lateral epicondylitis were assessed for the production of the cytokines IL-1β, IL-6, IL-8, IL-10 and TNF-α by immune-enzymatic assay (ELISA), after treatment with 1, 10 and 100 mM triamcinolone compared to untreated controls at the time points 6, 12, 18, 24, 48, 72 and 96 hours, and to PRP at 48, 72 and 96 hours.Results: The cytokines IL-6 and IL-8 were produced in high concentrations by lateral epicondylitis cells. Triamcinolone induced a significant decrease in the production of IL-6 and IL-8 at 48, 72 and 96 hours, and at 12 hours for IL-8. The PRP group produced significantly higher levels of IL-8 than the control group, at 96 hours. There was a significant increase in IL-10 production with the use of 100 μM triamcinolone at 48 hours, compared to controls. The production of IL1-β and TNF-α was very low and did not change when the cultures were treated with triamcinolone or PRP.Conclusion: Our results demonstrated that IL-6 and IL-8 plays a role in the pathogenesis of lateral epicondylitis. Triamcinolone inhibited the production of the production of IL-6 and IL-8 by lateral epicondylitis-derived cells and PRP induced an increase in IL-8 levels compared to controls.

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Section: Discussionmentioning

confidence: 99%

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

Viveiros

Silva

et al. 2021

Preprint

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“…5 PRP has been the discovery of the last decade in musculoskeletal medicine. 11,12 It's supposed effectiveness, apparent lack of side effects, autologous nature, low cost, and promising scope has made us try it for various chronic conditions. Starting with tendinopathies it has been tried in managing wound complications and as a means of postponing surgery in degenerative conditions like osteoarthritis of knee.…”

Section: Discussionmentioning

confidence: 99%

PRP in acromio-clavicular joint arthritis – A prospective analysis

C¹,

Sudhakar²,

Pst³

et al. 2021

IJOR

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Background: The acromioclavicular joint pathologies are one of the common causes of shoulder pain. The most common of these is the acromioclavicular joint arthritis. The management can be conservative or surgical. The conservative measures include activity modification, physiotherapy, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and Intra-articular Steroid Injections (ISI). ISI has been used with variable success rates and the long-term effects are doubtful. Materials and Methods: Patients with clinical and radiological evidence of ACJ arthritis and not responding to exercise and NSAIDs for 2 months were enrolled for PRP injection. 1 mL of PRP prepared by the manual double spin method was injected into the ACJ and patients were followed for a minimum period of 6 months. Constant Score was used to measure the functional recovery at 1, 3, and 6 months post-injection therapy. Results: 13 patients including 16 shoulders were followed up for an average of 8 months (6 to 14 months).3 patients had bilateral ACJ involvement. 4 had left ACJ involvement and the rest had right side involvement. The mean pre-injection constant score was 45 (range 28-70). The mean score at the end of 1 month follow up was 69 (range 56-89). At the end of 3 months, the mean score was 81 range (63-93). Both were statistically significant improvements when compared to the pre-injection score (P=0.003,0.0021respectively). At the end of 6 months, the score was 89 range . This sequential improvement was not however statistically significant. Conclusion: ACJ arthritis is one of the common causes of shoulder pain. In our pilot study, PRP has been a promising option to treat primary ACJ arthritis. Future RCTs are needed to establish it as a superior option in the management of ACJ arthritis.

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“…DASH score DASH score was reported in 11 of the included studies, 21,22,25,27,28,31,32,34,36,40,41 of which six studies 21,27,28,31,36,41 utilized LP-PRP involving 424 patients while rest 5 studies utilized LR-PRP involving 345 patients. There was a significant heterogeneity observed between the included studies.…”

Section: Vas For Painmentioning

confidence: 99%

“…Three studies 22,35,37 involving 168 patients utilizing LR-PRP reported functional outcomes based on Mayo Score without significant heterogeneity among them. (I 16 ¼ 99.169%, p ¼ 0.001).…”

Section: Mayo Elbow Performance Scorementioning

confidence: 99%

Comparative analysis of leucocyte poor vs leucocyte rich platelet-rich plasma in the management of lateral epicondylitis: Systematic review & meta-analysis of randomised controlled trials

Muthu

Patel

Selvaraj

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Study design: Systematic Review & Meta-analysis. Objectives: We aim to comparatively analyse the efficacy and safety of using leucocyte-poor platelet rich plasma (LP-PRP) against leucocyte-rich platelet rich plasma (LR-PRP) in the management of lateral epicondylitis. Materials and methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science and Cochrane Library till September 2020 for randomised controlled trials analyzing the efficacy and safety of LP-PRP and LR-PRP in the management of lateral epicondylitis. Visual Analog Score(VAS) for pain, Disabilities of the Arm, Shoulder and Hand (DASH) Score, Patient Reported Tennis-Elbow Evaluation (PRETEE) Score, Mayo Elbow Performance Score(MEPS) and adverse events were the outcomes analyzed. Analysis was performed in R-platform using OpenMeta[Analyst] software. Results: We performed a single arm meta-analysis of 26 studies involving 2034 patients. On analysis it was noted that significant improvement was noted in the VAS for pain (p < 0.001), DASH score (p < 0.001), PRETEE score (p < 0.001) and MEPS (p < 0.027) compared to their pre-operative state. No significant increase in adverse events were noted compared to the control group (p ¼ 0.170). While stratifying the results based on the type of PRP used, no significant difference was noted between the use of LP-PRP or LR-PRP in any of the above-mentioned outcome measures. Conclusion: PRP is a safe and effective treatment option for lateral epicondylitis with clinical improvements in pain and functional scores and both types of PRP (LR-PRP & LP-PRP) offer similar results.

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PRP versus steroids in a deadlock for efficacy: long-term stability versus short-term intensity—results from a randomised trial

Cited by 23 publications

References 23 publications

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

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

PRP in acromio-clavicular joint arthritis – A prospective analysis

Comparative analysis of leucocyte poor vs leucocyte rich platelet-rich plasma in the management of lateral epicondylitis: Systematic review & meta-analysis of randomised controlled trials

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