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PRP significantly improves Tennis Elbow symptoms

Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients.

Abstract

BACKGROUND:
Elbow tenderness and pain with resisted wrist extension are common manifestations of lateral epicondylar tendinopathy, also known as tennis elbow. Previous studies have suggested platelet-rich plasma (PRP) to be a safe and effective therapy for tennis elbow.

PURPOSE:
To evaluate the clinical value of tendon needling with PRP in patients with chronic tennis elbow compared with an active control group.

STUDY DESIGN:
Randomized controlled trial; Level of evidence, 2.

METHODS:
A total of 230 patients with chronic lateral epicondylar tendinopathy were treated at 12 centers over 5 years. All patients had at least 3 months of symptoms and had failed conventional therapy. There were no differences in patients randomized to receive PRP (n = 116) or active controls (n = 114). The PRP was prepared from venous whole blood at the point of care and contained both concentrated platelets and leukocytes. After receiving a local anesthetic, all patients had their extensor tendons needled with or without PRP. Patients and investigators remained blinded to the treatment group throughout the study. A successful outcome was defined as 25% or greater improvement on the visual analog scale for pain.

RESULTS:
Patient outcomes were followed for up to 24 weeks. At 12 weeks (n = 192), the PRP-treated patients reported an improvement of 55.1% in their pain scores compared with 47.4% in the active control group (P = .163). At 24 weeks (n = 119), the PRP-treated patients reported an improvement of 71.5% in their pain scores compared with 56.1% in the control group (P = .019). The percentage of patients reporting significant elbow tenderness at 12 weeks was 37.4% in the PRP group versus 48.4% in the control group (P = .143). Success rates for patients at 12 weeks were 75.2% in the PRP group versus 65.9% in the control group (P = .104). At 24 weeks, 29.1% of the PRP-treated patients reported significant elbow tenderness versus 54.0% in the control group (P = .009). Success rates for patients with 24 weeks of follow-up were 83.9% in the PRP group compared with 68.3% in the control group (P = .037). No significant complications occurred in either group.

CONCLUSION:
No significant differences were found at 12 weeks in this study. At 24 weeks, however, clinically meaningful improvements were found in patients treated with leukocyte-enriched PRP compared with an active control group.

Am J Sports Med. 2014 Feb;42(2):463-71. doi: 10.1177/0363546513494359. Epub 2013 Jul 3.

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Large Randomized Trial Confirms Value of Platelet Rich Plasma for Tennis Elbow Patients

Commentary on Platelet Rich Plasma, Stem Cells and Regenerative Medicine

84% of patients with chronic tennis elbow who had failed other non-operative treatments were successfully treated using platelet-rich plasma (PRP) in a large randomized trial.  The results were presented at the American Academy of Orthopedic Surgery Meeting in Chicago.

The study was a randomized, double-blind, multi-center controlled trial of 230 patients.  Patients received needling of their elbow tendons with and without PRP.  At 24 weeks the PRP patients reports a 71.5% improvement in their pain compared to 56.1 in the control group. (P = 0.027)  Patients treated with PRP also had less elbow tenderness at each follow up point. (See Graph Below)  Overall, 84% of the PRP patients were successfully treated compared to 68.3% of the control group. (P = 0.012)

This is the largest study done to date using PRP.  There are now over 340 patients who have been treated with the same system (Biomet GPS PRP) and techniques confirming the value of PRP as a treatment for chronic tennis elbow.  Importantly, there is also a decade long experience using PRP with an excellent safety profile.  PRP with this newly released data can now be confidently used for chronic tennis elbow patients prior to considering surgical intervention.

 

Source: http://bit.ly/17f91ZA

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