Tennis Elbow is a very common injury characterized by tenderness and pain on the outside of the elbow joint, where the extensor muscles of the forearm attach to the elbow, known as the Lateral Epicondyle. This localized inflammation can be excruciatingly painful during motions such as shaking hands or turning a doorknob. A common misnomer is that Tennis Elbow is frequently caused by poor technique while playing tennis. In fact, fewer than 5% of patients with this condition actually play tennis. It is most commonly caused by repetitive overuse from activities at the gym or excessive hours at the keyboard. Treating this condition can be tedious, time consuming and often times unsuccessful. Rest, massage, home exercises, braces, and topical creams are all potential treatment methods, and often a combination of several is recommended. However, in recent years, Platelet Rich Plasma (PRP) has emerged as a potentially viable treatment for treating Tennis Elbow.
Dr. Steven Sampson & Dr Danielle Aufiero as principal investigators, along with TOBI: The Orthobiologic Institute alumni Dr. Allan Mishra of Stanford University & Dr. David Karli of the Steadman Clinic in Vail recently published a randomized controlled multicenter trial examining the treatment of 230 patients suffering from chronic Tennis Elbow with PRP. All of the patients in the study had suffered from Tennis Elbow for longer than 3 months and failed conventional therapies. Half of the patients were needled with PRP injections to the inflamed tendon, while the other half were needled without PRP. Over the course of the 24 weeks follow up period, the results were measured via pain score improvements and tenderness
At the initial 12 weeks checkpoint, 55.1% of PRP-treated patients exhibited a 25% improvement in pain, while only 47.4% of control patients exhibited such improvements. However a much larger separation was seen at long term follow up of 24 weeks, with 71.5% of PRP treated patients illustrating clinically significant pain improvement (>25%), while only 56.1% of control patients met the clinical threshold. In addition, at 24 weeks, only 29.1% of PRP-treated patients admitted to elbow tenderness, versus 54% in the control group. The calculated overall success rates of the study revealed an 84% success rate in PRP-treated patients, Vs 68.3% in control patients.
The results of the study revealed clinically significant improvements in PRP-treated patients versus non-PRP groups, but only at long term follow up of 24 weeks. The study suggests PRP to be a potential treatment for chronic Tennis Elbow, illustrating improvements in pain and decreased elbow tenderness. Although most cases of Tennis Elbow will resolve within 2 years, ask anyone who has suffered from chronic Tennis Elbow, and they will tell you, that 2 years is a long time to experience such pain. The potential pain and tenderness improvements at 6 months seen with PRP treatment is an exciting new development and may provide an alternative treatment for accelerated healing time, and bring faster relief to the nagging pain. Although continued human trials are needed to completely investigate the efficacy of PRP for Tennis Elbow and other tendon injuries, this large randomized control trial has established a high degree of validation for the regenerative potential of PRP in this application.
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