title: Platelet-rich plasma injection reduces pain in patients with recalcitrant epicondylitis.
abstract: Thirty patients (31 elbows) with epicondylitis unresponsive to nonsurgical treatment (including steroid injection) for >6 months received a single treatment of platelet-rich plasma injected with a peppering technique. Patients were followed using a 5-subcategory visual analog scale (VAS) for pain (0, no pain; 10, worst possible pain), modified American Shoulder and Elbow Surgeons assessment survey, and VAS for patient satisfaction (0, not at all satisfied; 10, very satisfied). Successful treatment was defined as a 25% decrease in worst pain at follow-up with no intervention after 1 year. Two patients (2 elbows) elected for surgery 1 month postinjection. Of the remaining 29 elbows followed, 28 had a 25% reduction in worst pain at ≥1 follow-up visits, for an overall success rate of 90% (28 of 31 elbows). Mean scores for worst pain at baseline, 3 months, and last follow-up (patients with at least 6 months of follow-up; 25±14 months) were 7.2±1.6 (n=30 elbows), 4.0±2.2 (n=23), and 1.1±1.7 (n=26), respectively (P<.01 or less comparing follow-up scores to baseline using each patient as his or her own control). Patient satisfaction scores improved from 5.1±2.5 at 1 month to 9.1±1.9 at last follow-up (P<.01). Only 1 patient reported no improvement after 6 months. Results suggest that a single platelet-rich plasma injection can improve pain and function scores, thus avoiding surgery.
authors.affiliation: UHZ Sports Medicine Institute, Doctors Hospital, Baptist Health South Florida, Coral Gables, Florida 33146, USA.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Hechtman
authors.forename: John W
authors.initials: JW
authors.lastname: Uribe
authors.forename: Angie
authors.initials: A
authors.lastname: Botto-vanDemden
authors.forename: Gary M
authors.initials: GM
authors.lastname: Kiebzak
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017713:Platelet Transfusion / Q000379:methods*; D053657:Platelet-Rich Plasma; D011859:Radiography; D013716:Tennis Elbow / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome