title: Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up.
abstract: BACKGROUND
  Platelet-rich plasma (PRP) has shown to be a general stimulation for repair. Purpose To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis.
  
  
  METHODS
  Randomized controlled trial; Level of evidence, 1.
  
  
  METHODS
  The trial was conducted in 2 teaching hospitals in the Netherlands. One hundred patients with chronic lateral epicondylitis were randomly assigned in the PRP group (n = 51) or the corticosteroid group (n = 49). A central computer system carried out randomization and allocation to the trial group. Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering technique. The primary analysis included visual analog scores and DASH Outcome Measure scores (DASH: Disabilities of the Arm, Shoulder, and Hand).
  
  
  RESULTS
  Successful treatment was defined as more than a 25% reduction in visual analog score or DASH score without a reintervention after 1 year. The results showed that, according to the visual analog scores, 24 of the 49 patients (49%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was significantly different (P <.001). Furthermore, according to the DASH scores, 25 of the 49 patients (51%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was also significantly different (P = .005). The corticosteroid group was better initially and then declined, whereas the PRP group progressively improved.
  
  
  CONCLUSIONS
  Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateral epicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.
authors.affiliation: Department of Orthopaedic Surgery, HAGA Hospital, The Hague, Netherlands.
authors.forename: Joost C
authors.initials: JC
authors.lastname: Peerbooms
authors.forename: Jordi
authors.initials: J
authors.lastname: Sluimer
authors.forename: Daniël J
authors.initials: DJ
authors.lastname: Bruijn
authors.forename: Taco
authors.initials: T
authors.lastname: Gosens
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000494:pharmacology; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010146:Pain / Q000188:drug therapy; D053657:Platelet-Rich Plasma; D013716:Tennis Elbow / Q000188:drug therapy* / Q000534:rehabilitation; D014182:Transplantation, Autologous / Q000534:rehabilitation; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones