Abstract
Lateral epicondylitis is a common musculoskeletal problem that lacks a reliable therapy with consistent results. For the difficult cohort of patients that remain symptomatic despite conservative treatments, injections offer an important minimally invasive option prior to surgery.
The use of blood-based injections for cases of tendinopathy has gained popularity in orthopedics. Both autologous blood and platelet-rich plasma (PRP) injections have been used for lateral epicondylitis, with the theory that injections provide the body’s own growth factors to a potentially hypovascular site of injury. As compared to autologous blood, PRP injections deliver an increased concentration of growth factors at the expense of increased time, equipment, and cost for each treatment.
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References
Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol. 1974;3(3):145–53.
Verhaar JA. Tennis elbow. Anatomical, epidemiological and therapeutic aspects. Int Orthop. 1994;18(5):263–7.
Faro F, Wolf JM. Lateral epicondylitis: review and current concepts. J Hand Surg Am. 2007;32(8):1271–9.
Calfee RP, et al. Management of lateral epicondylitis: current concepts. J Am Acad Orthop Surg. 2008;16(1):19–29.
Nirschl RP, Ashman ES. Elbow tendinopathy: tennis elbow. Clin Sports Med. 2003;22(4):813–36.
Alfredson H, et al. In vivo investigation of ECRB tendons with microdialysis technique–no signs of inflammation but high amounts of glutamate in tennis elbow. Acta Orthop Scand. 2000;71(5):475–9.
Bales CP, et al. Microvascular supply of the lateral epicondyle and common extensor origin. J Shoulder Elbow Surg. 2007;16(4):497–501.
Smidt N, et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359(9307):657–62.
Foster TE, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009;37(11):2259–72.
Kampa RJ, Connell DA. Treatment of tendinopathy: is there a role for autologous whole blood and platelet rich plasma injection? Int J Clin Pract. 2010;64(13):1813–23.
Creaney L, et al. 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. Br J Sports Med. 2011;45(12):966–71.
Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg Am. 2003;28(2):272–8.
Wolf JM, et al. Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study. J Hand Surg Am. 2011;36(8):1269–72.
Ozturan KE, et al. Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis. Orthopedics. 2010;33(2):84–91.
Kazemi M, et al. Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: a randomized clinical trial of efficacy. Am J Phys Med Rehabil. 2010;89(8):660–7.
Dojode CM. A randomised control trial to evaluate the efficacy of autologous blood injection versus local corticosteroid injection for treatment of lateral epicondylitis. Bone Joint Res. 2012;1(8):192–7.
Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008;1(3/4):165–74.
Carofino B, et al. Corticosteroids and local anesthetics decrease positive effects of platelet-rich plasma: an in vitro study on human tendon cells. Arthroscopy. 2012;28(5):711–9.
Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34(11):1774–8.
Peerbooms JC, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38(2):255–62.
Gosens T, et al. 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):1200–8.
Krogh TP, et al. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013;41(3):623–35.
Stenhouse G, Sookur P, Watson M. Do blood growth factors offer additional benefit in refractory lateral epicondylitis? A prospective, randomized pilot trial of dry needling as a stand-alone procedure versus dry needling and autologous conditioned plasma. Skeletal Radiol. 2013;42(11)1515–20.
Mishra AK, et al. Platelet-rich plasma significantly improves clinical outcomes in patients with chronic tennis elbow: a double-blind, prospective, multicenter, controlled trial of 230 patients. Am J Sports Med. 2014;42(2):463–71.
Thanasas C, et al. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med. 2011;39(10):2130–4.
Mazzocca AD, et al. Platelet-rich plasma differs according to preparation method and human variability. J Bone Joint Surg Am. 2012;94(4):308–16.
Krogh TP, et al. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials. Am J Sports Med. 2013;41(6):1435–46.
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Judson, C., Wolf, J. (2015). Tennis Elbow: Blood and Platelet-Rich Plasma (PRP) Injections. In: Wolf, J. (eds) Tennis Elbow. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7534-8_8
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DOI: https://doi.org/10.1007/978-1-4899-7534-8_8
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