A study on management of tennis elbow by local platelet rich plasma injection


  • Wazir Fahad Jan Department of Orthopaedics, SHKM GMC, Nalhar, Haryana, India
  • Alamgir Jahan Department of Orthopaedics, GMC Haldwani, Uttrakhand, India
  • Mohd Yahya Dar Department of Orthopaedics, SHKM GMC, Nalhar, Haryana, India
  • Umer Mushtaq Khan Department of Critical Care and Pain Management, Max Superspeciality Hospital, New Delhi, India




Tennis elbow, Lateral epicondylitis, Platelet rich plasma


Background: Lateral epicondylitis (tennis elbow), a familiar term used to describe myriad symptoms around the lateral aspect of the elbow can occur during activities that require repetitive supination and pronation of the forearm with the elbow in near full extension. This condition can cause severe discomfort to the patient resulting in debilitation and impairment of routine activities. The purpose of this study was to evaluate the effectiveness of local autologous platelet rich plasma injection in the treatment of tennis elbow.

Methods: This was a prospective observational study conducted on 50 patients of either sex with an average age of 45.92 years, presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, NUH, Haryana between November 2016 and February 2018, with a diagnosis of lateral epicondylitis. All the patients were treated with local platelet rich plasma injection and the results were analysed through the assessment of visual analog score (VAS) and disability of arm shoulder and hand (DASH) score. The patients were followed up for a period of 6 months after the local injection of platelet rich plasma.

Results: Majority of the patients had significant relief with this method. The VAS and DASH score improved from the pre-treatment values of 8.7 and 74.6 to 2.6 and 29.8 respectively, which was found to be statistically significant (p<0.001).

Conclusions: Thus results of our study demonstrate that the local injection of platelet rich plasma is a safe and effective method of treatment of lateral epicondylitis.


Runge F. Zur Genese und Behandlung des Schreibekrampfes. Berl Klin Wochenschr. 1873;10:245.

Bisset L, Beller E, Jull G. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333:939.

Gellman H. Tennis elbow (lateral epicondylitis). Orthop Clin North Am. 1992;23:75.

Mills GP. The treatment of “tennis elbow”. BMJ. 1928;1:12.

Coonrad RW, Hooper WR. Tennis elbow: its course, natural history, conservative and surgical management. J Bone Joint Surg. 1973;55:1177.

Porretta CA, Janes JM. Epicondylitis of the humerus. Mayo Clin Proc. 1958;33:303.

Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg. 2003;28:272.

Boyd HB, McLeod Jr AC. Tennis elbow. J Bone Joint Surg. 1973;55:1183.

Osgood RB. Radiohumeral bursitis, epicondylitis, epicondylalgia (tennis elbow). Arch Surg. 1922;4:420.

Trethowan WH. Tennis elbow. BMJ. 1929;2:1218.

Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114:1502-8.

Everts PA, Knape JT, Weibrich G. Platelet-rich plasma and platelet gel: a review. J Extracorp Tech. 2006;38:174.

Weibrich G, Kleis WK, Hafner G. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Cranio-Maxillofacial Surg. 2002;30:97-102.

Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofacial Surg. 2000;58:297-300.

Bhanot S, Alex JC. Current applications of platelet gels in facial plastic surgery. Facial Plast Surg. 2002;18:27-34.

Mishra A, Woodall J, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med. 2009;28:113-25.

McAleer JP, Sharma S, Kaplan EM. Use of autologous platelet concentrate in a nonhealing lower extremity wound. Adv Skin Wound Care. 2006;19:354-63.

Bisset L, Beller E, Jull G. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333:939.

Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand. 2004;75:93-9.

Sanchez AR, Sheridan PJ, Kupp LI. Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Implants. 2003;18:93-103.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34:1774-8.

Peerbooms JC, Sluimer J, Bruijn DJ. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38:255-62.

Gupta SK, Venkatesh, Bandari D. Autologous platelet-rich plasma injection in tennis elbow and plantar fasciitis. Current Orthop Pract. 2016;27:405-8.






Original Research Articles