title: Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections.
abstract: BACKGROUND
  Growth factor technologies are increasingly used to enhance healing in musculoskeletal injuries, particularly in sports medicine. Two such products; platelet-rich plasma (PRP) and autologous blood, have a growing body of supporting evidence. No previous trial has directly compared the efficacy of these two methods.
  
  
  OBJECTIVE
  Growth factor administration improves tissue regeneration in patients who have failed to respond to conservative therapy.
  
  
  METHODS
  A prospective, double-blind, randomised trial.
  
  
  METHODS
  Elbow tendinopathy patients who had failed conservative physical therapy were divided into two patient groups: PRP injection (N=80) and autologous blood injection (ABI) (N=70). Each patient received two injections at 0 and 1 month. Patient-related tennis elbow evaluation (PRTEE) was recorded by a blinded investigator at 0, 1, 3 and 6 months. The main outcome measure was PRTEE, a validated composite outcome for pain, activities of daily living and physical function, utilising a 0-100 scale.
  
  
  RESULTS
  At 6 months the authors observed a 66% success rate in the PRP group versus 72% in the ABI group, p=NS. There was a higher rate of conversion to surgery in the ABI group (20%) versus the PRP group (10%).
  
  
  CONCLUSIONS
  In patients who are resistant to first-line physical therapy such as eccentric loading, ABI or PRP injections are useful second-line therapies to improve clinical outcomes. In this study, up to seven out of 10 additional patients in this difficult to treat cohort benefit from a surgery-sparing intervention.
authors.affiliation: BUPA Health and Wellbeing, London, UK. leoncreaney@hotmail.com
authors.forename: Leon
authors.initials: L
authors.lastname: Creaney
authors.forename: Andrew
authors.initials: A
authors.lastname: Wallace
authors.forename: Mark
authors.initials: M
authors.lastname: Curtis
authors.forename: David
authors.initials: D
authors.lastname: Connell
mesh_terms: D001804:Blood Transfusion, Autologous; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D057194:Intention to Treat Analysis; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010976:Platelet Count; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D013716:Tennis Elbow / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D036341:Intercellular Signaling Peptides and Proteins