title: Autologous Conditioned Plasma Versus Placebo Injection Therapy in Lateral Epicondylitis of the Elbow: A Double Blind, Randomized Study.
abstract: IntroductionThere are various therapeutic approaches to the treatment of lateral epicondylitis, a highly prevalent musculoskeletal disorder. Recently, injection therapy with autologous conditioned plasma (ACP) has shown promise as a new approach.MethodsSet up as a prospective, double-blind, randomized controlled clinical trial, this study involved 50 patients with lateral epicondylitis. Following external randomization, 25 patients received one round of injection therapy with ACP (platelet rich plasma, PRP), while the remaining 25 patients received a placebo of 0.9 % NaCl. All patients were re-evaluated with respect to lateral epicondylitis of the elbow at four-weeks and six-months post-injection.ResultsOut of 50 patients, 36 qualified for reevaluation, 18 patients from the ACP therapy group and 18 from the placebo group. The initial Disability of the Arm, Shoulder and Hand (DASH) score for all reevaluated patients was 36.4 in the ACP group, and 41.0 in the placebo group; both groups exhibited decreased DASH scores at the four-week and six-month post-injection follow-up (6 months: ACP 30.1, placebo 25.8). The decrease of the DASH score after 4 weeks was greater and qualified as statistically significant in the placebo group (p = 0.041), compared to the DASH score decrease in the ACP treatment group, which was statistically non-significant. Additionally, the difference between the DASH scores of the treatment and placebo groups was statistically non-significant four weeks and six months after treatment.DiscussionThe results of this study suggest a therapeutic effect in both the ACP and placebo groups, with no evidence for a therapeutically significant difference between ACP and placebo treatments. It is hypothesized that, in accordance with the study protocols, injection with a local anaesthetic prior to ACP therapy may have an influence on the therapeutic effect of ACP. Future studies have to confirm recent findings that demonstrated a minimizing, or even inhibiting, action of local anaesthetics on the effects of ACP/PRP.ConclusionThe effect of ACP/PRP injections needs to be investigated in future studies under standardized conditions.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Volker
authors.initials: V
authors.lastname: Schöffl
authors.affiliation: Alpha Med, Bamberg, FRG.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Willauschus
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Felix
authors.initials: F
authors.lastname: Sauer
authors.affiliation: Institute of Occupational and Social Medicine, RWTH Aachen Technical University, Aachen, FRG.
authors.forename: Thomas
authors.initials: T
authors.lastname: Küpper
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schöffl
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lutter
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Kolja
authors.initials: K
authors.lastname: Gelse
authors.affiliation: Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, Bamberg, FRG.
authors.forename: Jörg
authors.initials: J
authors.lastname: Dickschas
mesh_terms: D001691:Biological Therapy; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D013710:Tendons / Q000187:drug effects; D013716:Tennis Elbow / Q000628:therapy*