A comparative study of activated platelet rich plasma versus local corticosteroid injection for the treatment of lateral epicondylitis: A randomised study

Abstract

Background: Lateral epicondylitis (Tennis elbow) is due to degeneration in common origin of extensor group of muscles of forearm. The objective of our study was assessment of efficacy of activated platelet rich plasma and local corticosteroid injection for the treatment of lateral epicondylitis. Methods: 50 patients with chronic lateral epicondylitis were included in the study and randomised into 2 groups. Group 1 was treated with a single injection of 2 ml of autologous platelet rich plasma (4.8 times of plasma) with 1 ml of calcium chloride as activator and group 2 patients were infiltrated with 2 ml of local corticosteroid (methylprednisolone acetate 80 mg) mixed with 1 ml of 2 % lignocaine, followed by elbow strap, stretching and strengthening exercises along with oral non-steroidal anti-inflammatory drugs for both groups. Pain and functional outcomes were assessed using visual analogue scale (VAS) and NIRSCHL staging at 0, 1, 3, 6, weeks and 4 months and 8 months. Results: Pain variables including VAS and NIRSCHL scores improved significantly in both groups at short and intermediate duration, but long-term activated platelet rich plasma showed better improvement in regard to pain severity, functional outcome and recurrence rates. Conclusion: Both platelet rich plasma and local corticosteroid injection are effective to treat chronic lateral epicondylitis., But platelet rich plasma is better in both short-term and long-term follow-up in tennis elbow with no post injection exacerbation of pain in PRP cases.