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PRP; A Two-Year Outlook vs. Steroid Injection

Two-Year Follow-up of Injection with Platelet-Rich Plasma Versus Corticosteroid for Lateral Epicondylitis

Why you should pay attention to this:   This study followed up an earlier trial from 2010 that had shown clinical improvements in patients with tennis elbow treated with Platelet-Rich

Plasma (PRP) over patients treated with steroid injection.  It again assessed patient elbow pain and function two years’ out from treatment.  Differences between the steroid and PRP groups continued to become more pronounced, with deterioration in both pain and function in the steroid group relative to the PRP group.  Patients who were treated with PRP had better maintenance of improvements.  In addition, patients in the steroid group were allowed to cross over to the PRP group at one year, and these patients, as a group, had improved their pain and function scores as well.

This study does suffer from lack of a control group with no treatment.  This is potentially important, since the natural history of tennis elbow is for recovery 80% of the time within one year, even without specific treatment.  The deterioration of pain and function in patients treated with steroid in comparison with patients who received PRP could indicate that PRP is really a beneficial treatment, or that steroid injection actually results in worse patient outcomes relative to the natural history of this problem.  The improvement in patients in the cross-over phase would suggest the former.

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