04 Jun Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis!

“Cortisone verses PRP”

 Data was released from Krakow Poland at the International Meeting on the use of Autologous Growth Factors in Orthopedics and Sports Medicine: “State of the Art” – Krakow, Poland – 24 April 2009. The study found that patients receiving cortisone showed a 40% improvement compared to PRP 75% at 12 months. This is the first head to head study. Cortisone is well known to carry a risk of weakening & rupturing a tendon & is often discouraged.

Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis A double-blind randomized controlled trial: PRP versus corticosteroid injection with a 1 year follow-up.

Joost C. Peerbooms, Jordi Sluimer, Daniël J. Bruijn, Taco Gosens

Context: Platelet Rich Plasma (PRP) has shown to be a general stimulation for repair.

Objectives: To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis.

Design: A double blind randomized controlled trial with a one-year follow-up between May 2006 and January 2008.
Setting: The trial was conducted in two teaching hospitals in The Netherlands.
Patients: 106 patients with chronic lateral epicondylitis were randomly assigned in the PRP group or in the corticosteroid group. Randomization and allocation to the trial group were carried out by a central computer system.
Intervention: Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering needling technique.
Main Outcome Measures: The primary analysis included VAS and DASH scores.

Results: Successful treatment was defined as more than a 25% reduction in VAS or DASH score without a reintervention after 1 year. The results showed that 21 of the 55 patients (40 %) in the corticosteroid group and 38 of the 51 patients (75 %) in the PRP group were defined as successful with the VAS score, which was significant different (P < 0.001). 23 of the 55 patients (42 %) in the corticosteroid group and 36 of the 51 patients (71 %) patients in the PRP group were defined as successful with the DASH, which was also significantly different (P < 0.003).

Conclusions: Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateralepicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.
Trial registration: ClinicalTrials.gov. Identifier: 2007-004947-31.http://www.clinicaltrials.gov

Comments:

This is probably the most convincing evidence so far for the benefit of PRP for persistent tennis elbow and demonstrates similar success rates to surgery with a 75% success rate in significant pain improvement!

John Lieurance, D.C.

References
International Meeting on the use of Autologous Growth Factors in Orthopaedics and Sports Medicine: “State of the Art” – Krakow, Poland – 24 April 2009 . Arrest arthritis and pain.

If you or someone you know is struggling with a chronic injury or arthritis they might be a candidate for PRP. We have personally seen PRP and Prolotherapy change lives! As always our consultation is no charge so call 941 330-8553. Telephone consultations are also welcome.