Is Ultrasound (US)-Guided Platelet-Rich Plasma Injection More Efficacious as a Treatment Modality for Lateral Elbow Tendinopathy Than US-Guided Steroid Injection?: A Prospective Triple-Blinded Study with Midterm Follow-up.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. 19. J Orthop Res. 2018 Mar;36(3):913-920. doi: 10.1002/jor.23714. Epub 2017 Sep 20. Relationship of cytokine levels and clinical effect on platelet-rich plasma-treated lateral epicondylitis. Lim W(1)(2)(3), Park SH(4), Kim B(1)(2), Kang SW(1)(2), Lee JW(1)(2), Moon YL(1)(2). Author information: (1)Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea. (2)Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea. (3)Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea. (4)Run Orthopedic Hospital, Nam-gu, Gwangju, South Korea. Lateral epicondylitis (LE) is difficult to manage and can result in significant patient morbidity. Currently, the clinical use of platelet-rich plasma (PRP) for painful tendons has received attention, but its efficacy remains controversial. This study aimed to investigate the clinical effects of PRP and its biological components. A total of 156 patients with LE were randomly divided into group 1, treated with a single injection of 2-ml autologous PRP, and group 2, treated with a control received only physical therapy without injection. Both groups used a tennis elbow strap and performed stretching and strengthening exercises during 24 weeks' follow-up. Pain and functional improvements were assessed using the visual analog scale (VAS), Modified Mayo Clinic Performance Index for the elbow, and magnetic resonance imaging (MRI). White blood cell count, platelet count, and levels of platelet-derived growth factor-AB (PDGF-AB), PDGF-BB, transforming growth factor-β (TGF-β), vascular endothelial growth factor, epithelial growth factor, and interleukin-1 β in PRP were measured and investigated for statistical correlation with the clinical score. At 24 weeks, all pain and functional variables, including VAS score, Mayo Clinic performance scores, and MRI grade, improved significantly in group 1 (p