Efficacy of local injection of autologous platelet rich plasma in treatment of lateral epicondylitis

doi:10.3877/cma.j.issn.1674-134X.2018.05.003

Abstract

Abstract:

Objective

To investigate the effect of local injection of autologous platelet rich plasma in the treatment of lateral epicondylitis.

Methods

From January 2013 to January 2015, 60 patients with lateral epicondylitis undergent local injection therapy were randomly divided into two groups: PRP group (30 patients received autologous PRP)and glucocorticoid group(30 patients received prednisolone acetate and lidocaine). All the patients had the same accelerated rehabilitation protocol and were followed up in one, three, and 12 months. Evaluation consisted of inflammatory reaction, visual analogue scale(VAS), Mayo elbow performance score(MEPS)and disablities of the arm shoulder and hand(DASH)score. Independent samples t test was used to compared two groups, grade data used rank sum test. Overall differences in VAS , MEPS, DASH scores were analyzed by variance for repeated measurement data, differences at each time point were analyzed by independent samples t test.

Results

After the operation, no inflammatory reaction was in 28 cases of the PRP group and in 27 cases of the glucocorticoid group, mid inflammatory reaction in one case of PRP group and in two cases of glucocorticoid group, moderate inflammatory reaction in one case of PRP group and in one case of glucocorticoid group. In PRP group, the pretreatment, one month , three months and 12 months post-treatment VAS scores were (75±9), (64±8), (42±9), (21±9); DASH scores were (138±10), (113±10) , (82±10), (52±10) , MEPS scores were (25±4), (45±4), (63±4) , (82±4). In glucocorticoid group, the pretreatme, 1month, 3 months and 12 months post-treatment VAS scores were (74±9) , (53±9), (45±8), (55±9) , DASH scores were (133±11), (99±10), (85±10), (98±10), MEPS scores were (27±4), (54±4), (62±4), (47±5). Inflammatory reaction was not statistically significant different between the two groups (P>0.05). The total difference of VAS , DASH, MEPS score between the two groups were statistically significant(VAS F=15.98, P<0.01; DASH F=15.00, P<0.01 MEPS; F=68.98, P<0.01). One month and three months postoperative VAS, MEPS, DASH were statistically significant different in the PRP group and the glucocorticoid group(one month VAS t=5.0034, one month DASH t=5.4442, one month MEPS t=8.7142, P <0.05; 12 months VAS t=14.6313, 12 months DASH t=17.8157, 12 months MEPS t=29.9390, P<0.05), but three months postoperative VAS, DASH, MEPS differences were not statistically significant between the two groups (VAS t=1.3646, DASH t=1.1619, MEPS t=0.9682, P>0.05).

Conclusions

Antologous PRP and glucocorticoid local injection in the treatment of external humeral epicondylitis can alleviate pain, restore the function of elbow joint. Glucocorticoid may be better at the begining and then the effect will decline, whereas PRP can progressively improve effects without adverse effects, which is worthy of promotion in the clinic.

Key words: Platelet-rich plasma, Tennis elbow, Glucocorticoids, Pain

Peilong Dong, Xiaobo Tang, Jian Wang, Zhen’an Zhu. Efficacy of local injection of autologous platelet rich plasma in treatment of lateral epicondylitis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(05): 608-613.

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URL: https://zhgjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-134X.2018.05.003

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Figures/Tables 2

References 23

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组别	例数	男/女(例)	年龄[岁，(±s)]	侧别(左/右)	VAS评分(±s)	DASH评分(±s)	MEPS评分(±s)
PRP组	30	13/17	42±7	9/21	75±9	138±10	25±4
糖皮质激素组	30	14/16	43±7	8/22	74±9	133±11	27±4
统计值	?	χ²＝0.0673	t＝0.5533	χ²＝0.0821	t＝0.4303	t＝1.8422	t＝1.9365
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	男/女(例)	年龄[岁，(±s)]	侧别(左/右)	VAS评分(±s)	DASH评分(±s)	MEPS评分(±s)
PRP组	30	13/17	42±7	9/21	75±9	138±10	25±4
糖皮质激素组	30	14/16	43±7	8/22	74±9	133±11	27±4
统计值	?	χ²＝0.0673	t＝0.5533	χ²＝0.0821	t＝0.4303	t＝1.8422	t＝1.9365
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	炎性反应程度(无/轻/中)	治疗后1个月(±s)			治疗后3个月(±s)			治疗后12个月(±s)
组别	例数	炎性反应程度(无/轻/中)	VAS评分	DASH评分	MEPS评分	VAS评分	DASH评分	MEPS评分	VAS评分	DASH评分	MEPS评分
PRP组	30	28/1/1	64±8	113±10	45±4	42±9	82±10	63±4	21±9	52±10	82±4
糖皮质激素组	30	27/2/1	53±9	99±10	54±4	45±8	85±10	62±4	55±9	98±10	47±5
统计值	－	u＝0.4473	t＝5.0034	t＝5.4442	t＝8.7142	t＝1.3646	t＝1.1619	t＝0.9682	t＝14.6313	t＝17.8157	t＝29.9390
P值	－	>0.05	<0.01	<0.01	<0.01	>0.05	>0.05	>0.05	<0.01	<0.01	<0.01

组别	例数	炎性反应程度(无/轻/中)	治疗后1个月(±s)			治疗后3个月(±s)			治疗后12个月(±s)
组别	例数	炎性反应程度(无/轻/中)	VAS评分	DASH评分	MEPS评分	VAS评分	DASH评分	MEPS评分	VAS评分	DASH评分	MEPS评分
PRP组	30	28/1/1	64±8	113±10	45±4	42±9	82±10	63±4	21±9	52±10	82±4
糖皮质激素组	30	27/2/1	53±9	99±10	54±4	45±8	85±10	62±4	55±9	98±10	47±5
统计值	－	u＝0.4473	t＝5.0034	t＝5.4442	t＝8.7142	t＝1.3646	t＝1.1619	t＝0.9682	t＝14.6313	t＝17.8157	t＝29.9390
P值	－	>0.05	<0.01	<0.01	<0.01	>0.05	>0.05	>0.05	<0.01	<0.01	<0.01

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