Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline

Krogh, Thøger Persson; Fredberg, Ulrich; Stengaard‐Pedersen, Kristian; Christensen, Robin; Jensen, P. J.; Ellingsen, Torkell

doi:10.1177/0363546512472975

Cited by 305 publications

(190 citation statements)

References 57 publications

(74 reference statements)

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“…Peerbooms et al demonstrated a significant improvement in treating lateral epicondylitis with PRP vs. steroid injection: PRP demonstrated superiority up to 1 year posttreatment, with results remaining stable by the two-year mark [30]. A recent study suggested there is a negligible difference in treatment effectiveness between PRP, cortisone, and saline injections at 12 weeks posttreatment [31]. With this technique utilized, a high volume of lidocaine (10-15 ml) was injected into the paratenon prior to treatment which could adversely affect the outcome.…”

Section: Tendon Pathologymentioning

confidence: 99%

Clinical Aspects of Regenerative Medicine

Sampson

Bemden

Aufiero

2015

Translational Regenerative Medicine

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Section: Tendon Pathologymentioning

confidence: 99%

Clinical Aspects of Regenerative Medicine

Sampson

Bemden

Aufiero

2015

Translational Regenerative Medicine

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“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The most common reasons for exclusion were review paper (53), non-tendinopathy (14), injection of active control (7; eg, whole blood, PRP) and non-randomised study (7). Several manuscripts were excluded from this review because they were superseded by papers from the same study with longer follow-up including de Vos et al 29 30 and Peerbooms et al 31 A flow diagram of study identification and selection is shown in figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials

Miller

Parrish²,

Roides³

et al. 2017

BMJ Open Sport Exerc Med

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AimTo determine the efficacy of platelet-rich plasma (PRP) injections for symptomatic tendinopathy.DesignSystematic review of randomised, injection-controlled trials with meta-analysis.Data sourcesSystematic searches of MEDLINE and EMBASE, supplemented by manual searches.Eligibility criteria for selecting studiesRandomised controlled trials with 3 months minimum follow-up that evaluated pain reduction with PRP versus control (saline, local anaesthetic, corticosteroid) injections in patients with symptomatic tendinopathy.ResultsA total of 16 randomised controlled trials (18 groups) of PRP versus control were included. Median sample size was 35 patients, a study size that would require an effect size ≥1.0 to achieve statistical significance. PRP was more efficacious than control in reducing tendinopathy pain, with an effect size of 0.47 (95% CI 0.22 to 0.72, p<0.001), signifying a moderate treatment effect. Heterogeneity among studies was moderate (I2=67%, p<0.001). In subgroup analysis and meta-regression, studies with a higher proportion of female patients were associated with greater treatment benefits with PRP.ConclusionsInjection of PRP is more efficacious than control injections in patients with symptomatic tendinopathy.

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“…Several major clinical studies have examined the role of PRP in the treatment of lateral epicondylitis (Table 1) [40–44]. One of the earliest investigations was a cohort study of 20 patients who had refractory lateral epicondylitis for a mean of 15 months and all of them were considering surgical intervention.…”

Section: Autologous Blood Preparationsmentioning

confidence: 99%

New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis

Kahlenberg

Knesek

Terry

2015

BioMed Research International

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Lateral epicondylitis is a common source of elbow pain. Though it is often a self-limited condition, refractory lateral epicondylitis can lead to problems with activities of daily living and sometimes requires sick leave from work. Therefore prompt treatment is essential. Histopathologic studies have suggested that lateral epicondylitis is a tendinopathy, associated with apoptosis and autophagy, rather than a tendonitis associated with inflammation. Although corticosteroids have been used for short-term treatment, recent studies have suggested that they are not helpful and may even be harmful and delay healing in the treatment of lateral epicondylitis. Researchers have recently begun to investigate the use of biologics as potential treatment options for lateral epicondylitis. Autologous blood preparations including platelet rich plasma (PRP) and autologous whole blood injections (ABIs) have been proposed in order to deliver growth factors and other nutrients to the diseased tendon. Stem cell therapies have also been suggested as a method of improving tendon healing. This review discusses the current evidence for the use of PRP, ABI, and stem cell therapies for treatment of lateral epicondylitis. We also review the evidence for nonbiologic treatments including corticosteroids, prolotherapy, botulinum toxin A, and nitric oxide.

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Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline

Cited by 305 publications

References 57 publications

Clinical Aspects of Regenerative Medicine

Clinical Aspects of Regenerative Medicine

Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials

New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis

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