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Platelet-rich plasma for chronic lateral epicondylitis: Is one injection sufficient?

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Chronic lateral epicondylitis is generally treated using nonsurgical methods including physiotherapy and infiltrations of cortisone or platelet-rich plasma (PRP). The latter is known for its simple application as well as associated low risk of adverse events, which lend to its widespread use in treating various musculoskeletal conditions. There is limited evidence on the effectiveness of PRP injections to optimally treat chronic lateral epicondylitis. This study explored the effectiveness of single or repeated injections for patients with symptoms that spanned 6 months or more and were unresponsive to alternate conservative measures.

Methods and materials

Patients with chronic lateral epicondylitis received PRP injections in 4-week intervals that were complemented with standardized physical therapy. Patient-reported outcomes based on the patient-rated elbow evaluation (PREE), quick disabilities of the arm, shoulder and hand (qDASH), and EuroQol (five dimensions) 3-level version (EQ5D3L) questionnaires were documented at each visit including 6 months after the first injection. These outcomes were compared between patients receiving 1 vs. 2 or 3 PRP injections.

Results

Sixty-two patients received one (n = 36) or more (n = 26) PRP injections. The mean baseline to 6-month follow-up scores of the PREE and qDASH questionnaires improved significantly from 54.0 to 23.0 and 50.3 to 20.7, respectively. The mean baseline EQ5D3L-visual analogue scale score improved from 62.5 to 82.9 by 6 months post-injection. These outcomes did not significantly differ between the patients who received varying numbers of injections.

Conclusions

Patients with chronic lateral epicondylitis reported significant pain relief and gain in function as well as quality of life 6 months after localized PRP treatment. A single PRP injection may be sufficient.

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Acknowledgments

We wish to thank all clinicians of the Schulthess Clinic upper extremity and hand team for providing cases used in the clinical evaluation part of this study as well as our study nurses Franziska Kohler and Jessica Hohn for their valuable support. The authors would like also to thank M. Wilhelmi, Ph.D. for the preparation and editing of this manuscript.

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Authors and Affiliations

  1. Upper Extremities, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland

    Michael C. Glanzmann

  2. Research and Development, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland

    Laurent Audigé

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  1. Michael C. Glanzmann
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Correspondence to Laurent Audigé.

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Glanzmann, M.C., Audigé, L. Platelet-rich plasma for chronic lateral epicondylitis: Is one injection sufficient?. Arch Orthop Trauma Surg 135, 1637–1645 (2015). https://doi.org/10.1007/s00402-015-2322-7

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