Management of lateral epicondylitis (tennis elbow) by local infiltration of platelet rich plasma an outcome study

Authors

  • Pradeep Kumar Kumawat Department of Orthopaedics, J. L. N. M. C., Ajmer, Rajasthan, India
  • Rajesh Goel Department of Orthopaedics, G. M. C., Kota, Rajasthan, India
  • Urmila Kumhar Department of Orthopaedics, G. M. C., Kota, Rajasthan, India
  • Rahul Parmar Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India
  • Rajesh Sharma Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India
  • Bharat Sharma Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203715

Keywords:

Lateral epicondylitis, Platelet rich plasma injection, Visual analogue scale, Patient rated tennis elbow evaluation score

Abstract

Background: Platelet-rich plasma (PRP) has been recently the emerging biological therapy in which a large pool of signals released from platelets producing a biological microenvironment for local and migrating cells for tissue regeneration. A prospective randomized observational study was done to assess the efficacy of autologous PRP injection in lateral epicondylitis of elbow.

Methods: A total 100 patients of lateral epicondylitis were selected and treated from December 2015 to November 2017. VAS (visual analogue scale) and PRTEE (patient rated tennis elbow evaluation) scoring were used for clinical and functional assessment at pre-injection, 2nd week, 4th week, 3rd month and 6th month.

Results: At the end of 6 months follow-up 61% patients were completely relieved of pain. 34% patients had mild pain that was significantly decreased (p value <0.0001) from mean VAS (75) and mean PRTEE (78.62) to mean VAS (6.05) and mean PRTEE (5.63). 5 patients were lost their 6 months follow-up. There was a significant increase in post intervention pain for few days in 70% patients. Recurrence rate of 0% was noted at the end of 6 months follow-up.

Conclusions: An injection of PRP improves pain and function in patients suffering from lateral epicondylitis.

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Author Biographies

Pradeep Kumar Kumawat, Department of Orthopaedics, J. L. N. M. C., Ajmer, Rajasthan, India

senior resident in department of orthopaedics

Rajesh Goel, Department of Orthopaedics, G. M. C., Kota, Rajasthan, India

Senior Professor and unit head ,Orthopedic department, G.M.C ,Kota

Urmila Kumhar, Department of Orthopaedics, G. M. C., Kota, Rajasthan, India

B.D.S,M.sc(medical) microbiology ,J.L.N.M.C, Ajmer

Rahul Parmar, Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India

Former orthopedic residents, G.M.C ,Kota

Rajesh Sharma, Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India

Former orthopedic residents, G.M.C ,Kota

Bharat Sharma, Department of Microbiology, J. L. N. M. C., Ajmer, Rajasthan, India

Former orthopedic residents, G.M.C ,Kota

References

Runge F. For the genesis and treatment of the writing crane. Bed Klin Worchenschr. 1873;10:245-24.

Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065-74.

Regan W, Wold LE, Coonrad R, Morrey BF. Microscopic histopathology of chronic refractory lateral epicondylitis. Am J Sports Med. 1992;20(6):746-9.

Andia I, Abate M. Platelet rich plasma injections for tendinopathy and osteoarthritis. Int J Clin Rheumatol. 2012;7:397-412.

Aun C, Lam YM, Collect B. Evaluation of the use of visual analogue scale in Chinese patients. Pain. 1986;25:215-21.

MacDermid JC. The Patient-Rated Tennis Elbow Evaluation (PRTEE) User Manual. Hamilton, Canada: School of Rehabilitation Science, McMaster University. 2007. Available at: https://srs-mcmaster.ca/wp-content/uploads/2015/05/English-PRTEE-User-Manual_June-2010.pdf. Accessed on 12th April 2020.

Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10:225-8.

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62:498-93.

Bucholz RW, Einhorn TA, Marsh JL. Bone and joint healing. In: Bucholz RW, Heckman JD, Court-Brown C, eds. Rockwood and Green’s fractures in adults. Sixth ed. Lippincott Williams and Wilkins; 2006:300-11.

Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004;91:4-15.

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 Science, Med Rehab. 2014;6(1):12.

Omar Aziza S, Maha EI, Amal SA, Mahmoud S. Local injection of autologous platelet rich plasma and corticosteroid in treatment of lateral epicondylitis and plantar fasciitis: randomized clinical trial. Egypt Rheumatol. 2012;34:43-9.

Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med. 2011;39:2130-4.

Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013;41:625-35.

Gautam VK, Verma S, Batra S, Bhatnagar N, Arora S. Platelet-rich plasma versus corticosteroid injection for recalcitrant lateral epicondylitis: clinical and ultrasonographic evaluation. J Orthopaed Surg. 2015;23(1):1-5.

Yadav R, Kothari SY, Borah D. Comparison of local injection of platelet rich plasma and corticosteroids in the treatment of lateral epicondylitis of humerus. J Clin Diagnos Res. 2015;9(7):RC05.

Palacio EP, Schiavetti RR, Kanematsu M, Ikeda TM, Mizobuchi RR, Galbiatti JA. Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial. Rev Bras Ortop. 2016;51(1):90-5.

Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. 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.

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

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Published

2020-08-26

How to Cite

Kumawat, P. K., Goel, R., Kumhar, U., Parmar, R., Sharma, R., & Sharma, B. (2020). Management of lateral epicondylitis (tennis elbow) by local infiltration of platelet rich plasma an outcome study. International Journal of Research in Orthopaedics, 6(5), 963–967. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203715

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Original Research Articles