The Effect of Platelet-Rich Plasma on Elbow Tendinopathies: A Systematic Review

Abstract

Purpose: Elbow tendinopathies are common conditions that typically last 6 to 24 months. There is no clear consensus in the literature regarding the most effective management. Platelet-rich plasma (PRP) is an autologous blood product used for elbow tendinopathies with the aim of enhancing tissue regeneration. The aim of this systematic review was to evaluate the available evidence on the effectiveness and safety of PRP for reducing pain and physical function in elbow tendinopathies. Methods: Electronic databases were searched for relevant studies and data were extracted regarding the design, sample characteristics, interventions, and outcome measures. Each study was critically appraised for methodological quality using a modified tool for quantitative studies and presented in a narrative summary. Results: The search strategy identified 299 hits related to platelet-rich plasma and/or elbow tendinopathies. Five studies met the inclusion criteria; all were randomized controlled trials except one cohort study. All five studies showed improvements from baseline in pain and physical function with a PRP intervention. One study and its follow-up study showed significant improvements in pain and function with PRP compared to corticosteroid at 26, 52, and 104 weeks. Two studies compared PRP to whole blood, which did not find sufficient evidence to suggest one is more effective than the other. A cohort study found PRP was more effective than placebo at 4 and 8 weeks. Three studies reported on the safety of PRP and found no significant adverse effects. Conclusions: The current literature has some limitations and is insufficient to provide strong recommendations regarding the use of PRP in elbow tendinopathies over other modalities; however, these studies suggest that PRP may be more efficacious than corticosteroid injections, but that whole blood injections may be as effective as PRP.