JSWMC

Abstract:

Background: Lateral epicondylitis is a common overuse syndrome that shows variable outcome by traditional treatment methods because of poor tendon healing properties secondary to poor vascularization. Platelet rich plasma provides locally high concentration of growth factors and has shown its efficacy in the treatment of lateral epicondylitis.

Methodology: The study was a randomized clinical trial conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, from October 2018 to September 2019. Total 74 patients were purposively selected and randomly allocated in group A (received intra-lesional autologous PRP injection 2ml, counter force elbow orthosis, exercise, ADL and paracetamol) and group B (received counter force elbow orthosis, exercise, ADL and paracetamol). Outcome of treatment was measured using the Visual Analogue Scale (VAS) and Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire.

Results: Out of the 74 enrolled patients, 67 completed the study (33 in Group A, 34 in Group B). No significant differences in baseline demographic or clinical variables were noted between groups. Both groups showed significant improvements in VAS and PRTEE scores over time. However, Group A demonstrated significantly greater reductions in VAS scores at the 3^rd and 6^th months (p<0.001) and in PRTEE scores at the 6th month (p<0.05), compared to Group B. The mean VAS reduction was 5.6±0.7 in Group A versus 4.6±1.01 in Group B; mean PRTEE reduction was 39.3±10.1 in Group A versus 26±7.1 in Group B.

Conclusion: Autologous PRP injection is an effective treatment modality for lateral epicondylitis, providing superior pain relief and functional improvement compared to conventional conservative management. PRP therapy should be considered a valuable option in the treatment algorithm for chronic tendinopathies such as lateral epicondylitis.