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Trial shows greater pain relief for lateral epicondylitis with PRP than autologous blood

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PRAGUE — A platelet rich plasma injection treatment used in patients suffering from lateral epicondylitis for a minimum of 3 months was found to be an effective pain reduction measure, according to Greek investigators.

Athanassios Papanikolaou, MD, said the purpose of his study was to determine whether platelet rich plasma (PRP) offered any advantages for patients compared to a “simple, less expensive autologous blood treatment.”

In the trial conducted at Hellenic Red Cross Hospital, in Athens, 28 patients were block randomized into two groups of 14 patients each.

“Patients had symptoms for at least 3 months, no history of trauma, no previous injections, no history of rheumatic disorder and no signs of nerve involvement. The two groups were similar,” Papanikolaou said.

Under ultrasound guidance, the study group received a single, 3-ml PRP injection, while the control group received a single, 3-ml autologous blood injection. Papanikolaou noted the team used the Biomet GPS III system to prepare the PRP material without use of an activator. They took steps to ensure the concentration of PRP they used was sufficient, he said.

Two assessors who were blinded to the patients’ treatments on evaluated both groups using the Visual Analog Scale (VAS) for pain and the Liverpool elbow score for function at 6 weeks, 3 months and 6 months. One patient was lost to follow-up, Papanikolaou said.

Based on the results, VAS scores tended to be higher in the PRP group than in the control group. However, “The difference was only statistically significant at 6 weeks,” Papanikolaou said. At the 6-week follow-up, mean VAS scores improved 3.8 points in the study group and 2.5 points in the controls.

“At 6 months there was a 70% improvement in pain in the PRP group and 58% in the whole blood group,” he said.

Concerning the Liverpool elbow scores, they also improved in both groups, but the PRP group did slightly better than the control group. However, the difference in scores between the groups was not statistically significant.

“The only complication was local pain that gradually subsided at the site of the injection. This was seen in most patients in the PRP group (9 of 14),” Papanikolaou said.

Reference:

• Papanikolaou A, Thanassas C, Papadimitriou G, et al. Chronic lateral elbow epicondylitis treated with either platelet rich plasma or autologous whole blood. A randomized controlled clinical trial. Paper #29518. Presented at the SICOT XXV Triennial World Congress. Sept. 6-9, 2011. Prague.
• Disclosure: Papanikolaou has no relevant financial disclosures.