Platelet-rich plasma (PRP) is effective in reducing pain associated with chronic lateral elbow epicondylitis ("tennis elbow"), researchers from Greece report in the August 2 online issue of The American Journal of Sports Medicine.

"There is now a solution for patients suffering from unrelenting 'tennis elbow,'" Dr. Christos Thanasas from Henry Dunant Hospital, Athens, told Reuters Health in an email. "Whole blood treatment is a good alternative in remote areas or in health systems that do not support financially the use of PRP."

Dr. Thanasas and colleagues compared the effectiveness of single local injections of PRP under ultrasound guidance with autologous blood injections in 28 patients with chronic lateral epicondylitis.

Visual analog pain scores at 6 weeks after the injections were improved to a significantly greater extent in the PRP group (mean, 3.8 points; a 61.47% improvement) than in the autologous blood group (mean, 2.5 points; a 41.6% improvement).

Both groups experienced further improvements at 3 and 6 months after the injections, with no significant difference in pain scores between the treatments.

There were no differences between the treatments at any time point in the improvements in Liverpool functional score.

"PRP is probably the best treatment for chronic refractory lateral epicondylitis if it is used after classical types of treatment like rest, braces, nonsteroidal antiinflammatory drugs, cortisone injections, or physiotherapy have failed," Dr. Thanasas said. He added that the last resort is still surgical therapy.

"We are only in the beginning of clinical application of PRP in orthopedics," Dr. Thanasas said, adding that he supports studies of how and when PRP is most effective.

Dr. Thanasas added, "We are about to start a clinical trial using PRP on 'tennis elbow' examining the effect of WBC concentration in PRPs. We will compare two different types of PRP: one with a minimal concentration of WBC's and a second with higher levels to investigate the role of WBC's to promote tendon regeneration."

Am J Sports Med 2011. Abstract

Will Boggs MD • Reuters Health Information © 2011