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PRP and placebo treatment may be equally effective for epicondylitis pain
No significant differences in pain were observed following either treatment in results of a prospective, double-blind randomized trial.
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LAS VEGAS — A cohort of patients who underwent platelet-rich plasma treatment exhibited similar reductions in lateral epicondylitis pain to that seen in patients who received placebo injections, according to data presented here.
Investigators evaluated 25 patients with a mean age of 47 years who underwent treatment for lateral epicondylitis with Autologous Conditioned Plasma (ACP; Arthrex) between 2011 and 2012. Patients were eligible for study inclusion if they exhibited epicondylitis within 3 months of the beginning of the study, which was confirmed by MRI and/or ultrasound.
Mathieu Ferrand, MD, who presented the findings, and colleagues matched these patients to 25 controls with a mean age of 46.4 years who had lateral epicondylitis and underwent saline injection treatment. Both cohorts received two ultrasound-guided injections at 4-week intervals after initial treatment (ACP vs. saline). Patients who exhibited a history of corticosteroid infiltration were excluded from both cohorts.
The primary metric for the analysis was change in pain score from baseline to 6 months after treatment. The investigators performed a pain assessment on isometric contraction of the second radial and the extensor digitorum communis to determine the patients with persistent pain. They also analyzed results of the Roles-Maudsley score. Six patients — three in each cohort — removed themselves from the study in the time between initial treatment and 6-month follow-up.
“The potential stimulating role of ultrasound-guided intratendinous injections may affect tendon repair,” Ferrandsaid.
Overall, the mean improvement in pain was 63.2 in the ACP cohort and 69.7 in the control cohort, a difference that was not statistically significant. No adverse effects were seen in either group.
The percentage of patients who did not exhibit symptoms of epicondylitis at 6 months and 1 year post-treatment was 34% in the ACP cohort and 66% in the control cohort. Pain scores at baseline in the ACP and control cohorts were 6.8 points and 7.1 points, respectively, and they decreased significantly at 6 months follow-up to 2.5 points and 2.1 points, respectively, according to the results.
The trend for decreased pain continued at 1 year after treatment as reflected by pain scores of 1.65 points and 1.8 points, respectively.
At the 1-year follow-up, 23.8% of patients in both cohorts reported having some persistent pain. – by Christian Ingram
- Reference:
- Hardy P, et al. Paper #292. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.
- For more information:
- Mathieu Ferrand, MD, can be reached at Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; email: mferrand75@gmail.com.
Disclosure: Ferrand reports no relevant financial disclosures.