A Study of Clinical Profile and Functional Outcome of Lateral Epicondylitis Post PRP Injection

Abstract

Introduction: Lateral epicondylitis also known as tennis elbow attributed the onset of symptoms due to overexertion of the extremity with repeated wrist extension and alternating forearm pronation and supination. In Lateral epicondylitis , the mainstay of management which involves a variety of options, including rest, physical therapy, non steriodalanti inflammatory drugs (NSAIDS), local cortisone injection, autologous Platelet-Rich Plasma injection , botulinum toxin injections, shockwave therapy , supportive forearm bracing and local modalities. For patients with recalcitrant disease, open debridement technique, arthroscopic or percutaneous procedures are tried. Despite its high prevalence the development of a single effective and consistent management remains an unrealized goal. Aim: To study the effictiveness of autologous Platelet -rich plasma injections and look for best available treatment in the management of Lateral epicondylitis of humerus. We focused on comparing different modalalties of treatment for lateral epicondylitis and drew a conclusion after evaluating merits and demerits of the same.Methodology: All patients were included in the study after full filling the inclusion criteria and informed consent. Total 25 patients were included in the study of who did not get relief from conservative management were selected. All patients were treated with three injections of autologous PRP and followed up for a minimum period of six months. The treatment options were discussed before the procedure with patients and close relatives and an informed consent was taken for the study. The primary analysis included local tenderness, Grip test, Cozen test, The Disabilities of the Arm, Shoulder and Hand(DASH) score , Nirschl Pain Score and Visual Analogue Scale(VAS) for pain which were used for clinically assessing the outcome and improvement at different follow up periods of 1,4 and 24 weeks.Conclusion: The results obtained in this study indicate that autologous Platelet Rich Plasma injection in patients with Lateral Epicondylitis produced significant improvement in reducing pain, restoring functions and returning to previous activities. It also did not provoke any local or systemic adverse effects. The safety of autologous PRP makes it an attractive option for the treatment of lateral epicondylitis.