A Comparative Study Of Intralesional PRP Injections Versus Conventional Steriod Injections In The Treatment Of Chronic Lateral Epicondylitis (Tennis Elbow )

Authors

  • Henry Kurian Senior Resident,Department of Orthopedics, Pushpagiri Institute Of Medical Sciences , Thiruvalla Kerala (Affiliated to Kerala University of Health and Allied Sciences),India
  • John George Professor,Department of Orthopedics, Pushpagiri Institute Of Medical Sciences , Thiruvalla Kerala (Affiliated to Kerala University of Health and Allied Sciences),India

Keywords:

Lateral epicondylitis; platelet rich plasma; corticosteroids.

Abstract

Introduction: Tennis elbow or lateral epicondylitis (LE), is one of the most common and painful musculo-skeletal conditions, which has a significant impact on the healthcare industry and society. The disease mostly affects people aged between 35–50 years, who have a history of repetitive activities involving the upper limb. LE is more of a localised degenerative condition than an inflammatory one. The disease affects the normal healing potential of the tendon. Definitive management of chronic Lateral epicondylitis remains a challenge, considering its high rate of recurrence and episodes that can last from 6 months to 2 years. Materials and Methods: The Study was planned and conducted as a longitudinal observational study in Orthopaedics department, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, from January 2018 to June 2019. Forty-four patients with chronic lateral epicondylitis refractory to NSAIDS and physical measures were included in the study, of which half of the patients consulted one orthopaedician who uses corticosteroid (methyl prednisolone) as a treatment for refractory Lateral Epicondylitis and the other 22, consulted an orthopaedician who uses PRP for the same. Diagnosis was made after clinical evaluation and after other causes for the symptoms ruled out. The primary analysis included Visual Analogue Scale (VAS) scores for pain and Mayo Elbow Scores for functional improvement. Patients were given injections on day 1 and then after 1 month and finally at two months. They were called in for follow up at 26 weeks and VAS and Mayo scorings were done. The values were compared with the initial values and statistically assessed for any significant variation.Results: Successful treatment was defined as more than 25% a reduction in VAS score OR more than 25 percent improvement in Mayo elbow scores. The results showed that, at the end of 26 weeks, a mean reduction in VAS score of 6.14 was achieved, among patients in the PRP group as compared to a reduction in VAS score of 5.5 at 26 weeks in steroid group. The improvement in VAS score was statistically significant (P = 0.02) for the patients in PRP group. Furthermore, according to the Mayo scores, of the 22 patients, all 22 patients showed improvement in function among patients in the PRP group. The PRP group of patients reported more reduction in pain than the Corticosteroid group of patients at the end of 26 weeks.Conclusion: PRP injection relieves pain significantly and also improves function, exceeding the effect of corticosteroid injections at 26 weeks. Future decisions for application of PRP for lateral epicondylitis should be confirmed by further long-term follow-up and should take into account possible costs and harmful effects as well as benefits.

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Published

2021-05-27

How to Cite

Henry Kurian, & John George. (2021). A Comparative Study Of Intralesional PRP Injections Versus Conventional Steriod Injections In The Treatment Of Chronic Lateral Epicondylitis (Tennis Elbow ). International Journal of Health and Clinical Research, 4(10), 122–130. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/1614