title: Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial.
abstract: BACKGROUND
  Chronic lateral elbow epicondylitis is a tendinosis with angiofibrolastic degeneration of the wrist extensors' origin. Healing of this lesion is reported with the use of autologous blood as well as with platelet-rich plasma (PRP).
  
  
  OBJECTIVE
  A comparative study of these 2 treatments was conducted in an effort to investigate the possible advantages of PRP.
  
  
  METHODS
  Randomized controlled trial; Level of evidence, 1.
  
  
  METHODS
  Twenty-eight patients were divided equally into 2 groups, after blocked randomization. Group A was treated with a single injection of 3 mL of autologous blood and group B with 3 mL of PRP under ultrasound guidance. A standardized program of eccentric muscle strengthening was followed by all patients in both groups. Evaluation using a pain visual analog scale (VAS) and Liverpool elbow score was performed at 6 weeks, 3 months, and 6 months.
  
  
  RESULTS
  The VAS score improvement was larger in group B at every follow-up interval but the difference was statistically significant only at 6 weeks, when mean improvement was 3.8 points (95% confidence interval [CI], 3.1-4.5) in group B (61.47% improvement) and 2.5 points (95% CI, 1.9-3.1) in group A (41.6% improvement) (P < .05). No statistically significant difference was noted between groups regarding Liverpool elbow score.
  
  
  CONCLUSIONS
  Regarding pain reduction, PRP treatment seems to be an effective treatment for chronic lateral elbow epicondylitis and superior to autologous blood in the short term. Defining details of indications, best PRP concentration, number and time of injections, as well as rehabilitation protocol might increase the method's effectiveness. Additionally, the possibility of cost reduction of the method might justify the use of PRP over autologous whole blood for chronic or refractory tennis elbow.
authors.affiliation: Henry Dunant Hospital, Athens, Greece. dr.thanasas@gmail.com
authors.forename: Christos
authors.initials: C
authors.lastname: Thanasas
authors.forename: George
authors.initials: G
authors.lastname: Papadimitriou
authors.forename: Charalambos
authors.initials: C
authors.lastname: Charalambidis
authors.forename: Ilias
authors.initials: I
authors.lastname: Paraskevopoulos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Papanikolaou
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D013716:Tennis Elbow / Q000191:economics / Q000628:therapy*; D016896:Treatment Outcome