Efficacy of Platelet-Rich Plasma Versus Steroids In Patients  of Tennis Elbow

Muhammad Nouman Iqbal; Muhammad Omar Rathore; Javaid Iqbal Niazi; Asif Rasheed; Shafkat Hussain

doi:10.51253/pafmj.v74i4.10129

Authors

Muhammad Nouman Iqbal Department of Orthopedic, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Omar Rathore Department of Orthopedic, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Javaid Iqbal Niazi Department of Orthopedic, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Asif Rasheed Department of Orthopedic, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Shafkat Hussain Department of Orthopedic, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.10129

Keywords:

Corticosteroids; Platelet rich plasma; Tennis elbow

Abstract

Objective: To compare the efficacy of Platelet Rich Plasma versus Steroids among patients managed for Tennis elbow at our Orthopaedic unit.

Study Design: Quasi-experimental study.

Place and Duration of Study: Orthopaedic Department, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2021 to Jul 2022.

Methodology: Patients with Tennis Elbow diagnosed by a consultant orthopaedic surgeon were included in the study. They were randomly allocated treatment with platelet-rich plasma and steroid injections. The team assessed them after three months of treatment using the Disabilities of Arm, Shoulder, and Hand score. Different factors, including mode of treatment, were associated with significant improvement in these patients at the end of three months.

Results: Out of 250 patients with tennis elbow included in the final analysis, 193(77.2%) were male, and 57(22.3%) were female. Patients were divided into two groups for comparison, and Group-1 had significant improvement, while Group-2 had no improvement. Out of the total, 117(46.8%) patients received platelet-rich plasma, while 133(53.2%) patients were managed with corticosteroids. The presence of comorbid illnesses and the use of platelet-rich plasma was statistically significantly found in a group with significant improvement in Disabilities of Arm, Shoulder, and Hand score (p-value<0.05) as compared to a group of patients without significant improvement.

Conclusion: Most patients had significant improvement in symptoms at the end of three months. In our study, patients who were managed with platelet-rich plasma and had no comorbid illness had more chances of significant improvement at the end of three months.

Downloads

Download data is not yet available.

References

Yoshimura N, Iidaka T, Horii C, Mure K, Muraki S, Oka H, et al. Epidemiology of locomotive syndrome using updated clinical decision limits: 6-year follow-ups of the ROAD study. J Bone Miner Metab 2022; 10(3): 3-6.

https://doi.org/10.1007/s00774-022-01324-8

Mohsin Z, Asghar AA, Faiq A, Khalid I, Haque IU, Rehman S, et al. Prevalence of Rheumatic Diseases in a Tertiary Care Hospital of Karachi. Cureus 2018; 10(6): e2858.

https://doi.org/10.7759/cureus.2858

Cho Y, Yeo J, Lee YS, Kim EJ, Nam D, Park YC, et al. Healthcare Utilization for Lateral Epicondylitis: A 9-Year Analysis of the 2010-2018 Health Insurance Review and Assessment Service National Patient Sample Data. Healthcare 2022; 10(4): 636. https://doi.org/10.3390/healthcare10040636

Lai WC, Erickson BJ, Mlynarek RA, Wang D. Chronic lateral epicondylitis: challenges and solutions. Open Access J Sports Med 2018; 9(3): 243-251.

https://doi.org/10.2147/OAJSM.S160974

Kim GM, Yoo SJ, Choi S, Park YG. Current Trends for Treating Lateral Epicondylitis. Clin Shoulder Elbow 2019; 22(4): 227-234. https://doi.org/10.5397/cise.2019.22.4.227

Herald J, Ashraf M, Sundar MS, Rajan DV. Lateral Epicondylitis-Narrative Review on Surgical Options for Recalcitrant Cases. Indian J Orthop 2021; 55(2): 318-324.

https://doi.org/10.1007/s43465-021-00364-y

Li A, Wang H, Yu Z. Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis. Medicine 2019; 98(51): e18358.

https://doi.org/10.1097/MD.0000000000018358

Xu Q, Chen J, Cheng L. Comparison of platelet rich plasma and corticosteroids in the management of lateral epicondylitis: A meta-analysis of randomized controlled trials. Int J Surg 2019; 67(2): 37-46.

https://doi.org/10.1016/j.ijsu.2019.05.003

Seetharamaiah VB, Gantaguru A, Basavarajanna S. A comparative study to evaluate the efficacy of platelet-rich plasma and triamcinolone to treat tennis elbow. Indian J Orthop 2017; 51(3): 304-311.

https://doi.org/10.4103/ortho.IJOrtho_181_16

Memon IA, Junejo S, Khan KM, Ali Z, Butt SA, Memon FA. The Comparison of Efficacy of Platelet Rich Plasma (PRP) with Methylprednisolone in Patients with Tennis Elbow. Pak Armed Forces Med J 2022; 72(Suppl-2): S333-336.

https://10.51253/pafmj.v72iSUPPL-2.6842

Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, Vermillion DA, et al. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med 2014; 42(2): 463-471.

https://doi.org/10.1177/0363546513494359

Di Filippo L, Vincenzi S, Pennella D, Maselli F. Treatment, Diagnostic Criteria and Variability of Terminology for Lateral Elbow Pain: Findings from an Overview of Systematic Reviews. Healthcare 2022; 10(6): 1095.

https://doi.org/10.3390/healthcare10061095

Karjalainen T, Richards B, Buchbinder R. Platelet-rich plasma injection for tennis elbow: did it ever work? BMJ Open Sport Exerc Med. 2022 Jan 11; 8(1): e001258.

https://doi.org/10.1136/bmjsem-2021-001258

Kemp JA, Olson MA, Tao MA, Burcal CJ. Platelet-Rich Plasma versus Corticosteroid Injection for the Treatment of Lateral Epicondylitis: A Systematic Review of Systematic Reviews. Int J Sports Phys Ther 2021; 16(3): 597-605.

https://doi.org/10.26603/001c.24148

Koorevaar RCT, Kleinlugtenbelt YV, Landman EBM, van 't Riet E, Bulstra SK. Psychological symptoms and the MCID of the DASH score in shoulder surgery. J Orthop Surg Res 2018; 13(1): 246. https://doi.org/10.1186/s13018-018-0949-0

Marwaha V, Pawah AK, Muthukrishnan J, Kumar KVSH. Combined steroid and lignocaine injection in resistant cases of tennis elbow: A prospective, interventional study from India. J Family Med Prim Care 2017 ; 6(3): 498-501.

https://doi.org/10.4103/2249-4863.222032

Tang S, Wang X, Wu P, Wu P, Yang J, Du Z, et al. Platelet-Rich Plasma Vs Autologous Blood Vs Corticosteroid Injections in the Treatment of Lateral Epicondylitis: A Systematic Review, Pairwise and Network Meta-Analysis of Randomized Controlled Trials. Phys Med Rehab 2020; 12(4): 397-409. https://doi.org/10.1002/pmrj.12287

Gupta PK, Acharya A, Khanna V, Roy S, Khillan K, Sambandam SN. PRP versus steroids in a deadlock for efficacy: long-term stability versus short-term intensity-results from a randomised trial. Musculoskelet Surg 2020; 104(3): 285-294. https://doi.org/10.1007/s12306-019-00619-w

Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 2011; 39(6): 1200-1208.

https://doi.org/10.1177/0363546510397173