Comparative evaluation of the efficacy of Platelet Rich Plasma Versus Triamcinolone in Treating Tennis elbow
Abstract
Background: Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection & other modes of conservative management. Hence, this study was done to compare the efficacy of PRP and triamcinolone injection in tennis elbow.
Material &Methods: This randomized study was conducted at our center, for a period of two years from Aug 2015 to Sep 2017 on 60 consenting patients diagnosed as lateral epicondylitis. Patients were randomized into Group –1 (30 patients) receiving 2 ml of PRP injection and group –2 (30 patients) receiving 2 ml of Triamcinolone injection. Post therapy assessment was done using with Oxford elbow score.
Results: Average age at presentation was 31.11 year (range 20 to 40). Mean Oxford Elbow Score for both PRP injection group and in triamcinolone group at 6 weeks, 3 month and 6 month improved from pre injection score with p-value less than 0.001, thus stating that both PRP and triamcinolone injections works very well. On comparing PRP with triamcinolone, we found that PRP was slight better than the triamcinolone injection and was better maintained in long term in PRP group.
Conclusion: Lateral epicondylitis or Tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments.
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References
2. Croisier JL, Foidart-Dessalle M, Tinant F, Crielaard JM, Forthomme B. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. Br J Sports Med. 2007;41:269-75.
3. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev. 2005;4:CD003524.
4. Borrione P, Gianfrancesco AD, Pereira MT, Pigozzi F. Platelet-rich plasma in muscle healing. Am J Phys Med Rehabil. 2010;89(10):854–61.
5. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 2006;34(11):1774–8.
6. Mishra A, Collado H, Fredericson M. Platelet-rich plasma compared with corticosteroid injection for chronic lateral elbow tendinosis PM R. 2009;1(4):366–70.
7. Raeissadat SA, Rayegani SM, Hassanabadi H, Rahimi R, Sedighipour L, Rostami K. Is Platelet- rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial. BMC Sports Sci Med Rehabil. 2014;18(6):12.
8. Dawson J, Doll H, Boller I, Fitzpatrick R. The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery. J Bone Joint Surg Br 2008;90:466-73.
9. Hamilton P. The prevalence of humeral epicondylitis: a survey ingeneral practice. J R Coll Gen Pract 1986;36:464-5.
10. Kivi P. The etiology and conservative treatment of humeral epicondylitis. Scand J Rehabil Med 1983;15:37-41.
11. Ono Y, Nakamura R, Shimaoka M, Hiruta S, Hattori Y, Ichihara G, et al. Epicondylitis among cooks in nursery schools. Occup Environ Med 1998;55:172-9.
12. Ritz BR. Humeral epicondylitis among gas and waterworks employees. Scand J Work Environ Health. 1995;21:478-86.
13. Struijs PA, Smidt N, Arola H, Dijk VC, Buchbinder R, Assendelft WJ. Orthotic devices for the treatment of tennis elbow. Cochrane Database Syst Rev. 2002;1:CD00182.
14. Everts PA, Knape JT, Weibrich G, Schönberger JP, Hoffmann J, Overdevest EP, et al. Platelet-rich plasma and platelet gel: a review. J Extra Corpor Technol. 2006;38:174-87.
15. Anitua E, Andía I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, et al. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res. 2005;23:281-6.
16. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am. 2003; 28(2):272-278.
17. Connell D, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M. Ultrasound-guided autologous blood injection for tennis elbow. Skeletal Radiol 2006;35(6):371-7.
18. Saartok T, Eriksson E. Randomized trial of oral naproxen or local injection of betamethasone in lateral epicondylitis of the humerus. Orthop 1986;9(2):191-4.
19. Ozturan KE, Yucel L, Cakici H, Guven M, Sungur I. Autotogous blood and corticosteroid injection and extracoporeat shock wave therapy in the treatment of lateral epicondylitis. Orthop 2010;33(2):84-91.
20. Gani NU, Khan HA, Kamla Y, Farooq M, Shah AB. Long term result in refractive tennis elbow using autologous blood. Orthop Rev. 2004;6(4):5473.
21. Verhaar JA1, Walenkamp GH, van Mameren H, Kester AD, van der Linden AJ. Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow. J Bone Joint Surg Br. 1996;78(1):128-32.
22. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39(7):411–422.
23. Jain S, Banodha L, Kelkar R, Gautam V. Objective evaluation of tendon morphology by ultrasonography in treatment of recalcitrant tennis elbow by autologous platelet rich plasma. Orthop J MPC 2019:25(1):23-29.
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