A randomized control trial to compare the efficacy of intralesional platelet rich plasma vs steroid in lateral epicondylitis: A prospective interventional study

Abstract

Background: lateral epicondylitis most commonly known as tennis elbow is not a rare entity. Most commonly seen in working population causing many work hour losses and thus leads to loss of income. Severity ranges from occasional pain to continuous dull aching leading to frustration and hindering the daily activities. It’s a common practice to treat this condition with intralesional steroids. However, the recent developments in treatment advocates use of PRP in place of steroids. Hence, we conducted this study to compare and see the efficacy of both.Methods: This is a prospective interventional study of 40 cases of lateral epicondylitis visited to our tertiary care private hospital during 2019 to 2020. Patients not amenable to analgesic were treated with intralesional steroid and PRP. 20 patients of each group received the treatment in double blinded randomised control fashion. Each patient assessed at regular interval for a period of 24 weeks and pain analysed with the help of VAS, FPS scoring and functional improvement with DASH score. Results were analysed with appropriate statistical method.Results: In our study pre injection VAS score was comparable in both groups. The difference of pre injection VAS score was not much significant statistically. Both group of patients showed improvement in pain and functionality, reflected by decreasing VAS, FPS and DASH scores at 4 and 8 weeks. However, at 12- and 24-weeks improvement achieved with PRP was much better than the steroid. In the steroid group they cease to improv after 12 months and some patients even started experiencing pain again at 24 weeks. There is a significance difference between the two groups outcome seen at 24 weeks. Percentage of effect along with effect size achieved is also large in PRP group.Conclusions: Both steroid and PRP are good for short term pain relief in management of lateral epicondylitis. However, in long term and sustained pain control PRP showed better outcome than steroid. Risk of recurrence is high with steroid than with the PRP.