Downloads: 3 | Views: 68 | Weekly Hits: ⮙1 | Monthly Hits: ⮙1
Research Paper | Orthopedic | India | Volume 12 Issue 7, July 2023
Comparative Analysis of Platelet Rich Plasma and Corticosteroid Injection in Lateral Epicondylitis
Dr. Gaurav Menwal | Dr. Suffiyan Ahmed | Dr. Avinash Rastogi
Abstract: Background: Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle - aged patients that is associated with local tendon pathology, alteration in pain perception and motor impairment. Several approaches to conservative treatment have been proposed, the most frequently used is PRP. Platelet - rich plasma (PRP) is a growing modality for tissue healing, regeneration and has more pain relief lasting effect. Aim of the work: was to evaluate the outcome of platelet - rich plasma injections and to compare the results of platelet - rich plasma injections in the treatment of lateral epicondylitis in terms of pain relief and functional improvement with corticosteroid injection quoted in literature. Patients and Methods: This was a prospective study conducted on 45patients with symptomatic lateral epicondylitis (site of pain and tenderness) diagnosed with clinical examination like COZEN?S TEST (pain elicited with the active extension of the wrist with the forearm in pronation and elbow in extension) and WRINGING TEST were included in the study. Patients aged 18 years or above with closed physis of either sex with the clinical diagnosis of lateral epicondylitis not responding to conservative treatment like NSAIDs, rest, or hot fomentation in the last 3 - 6 months were included in the study. Patients with a history of acute elbow trauma, elbow arthritis, patients requiring anti - platelet medication for the treatment of ischemic heart disease, cerebrovascular accidents or other medical conditions, any previous elbow surgeries, other causes of elbow pain such as Osteochondritis of the capitulum, Posterior interosseous nerve syndrome, synovitis of radio humeral joint, cervical radiculopathy were excluded. Freshly prepared PRP of 1 ml was injected at the most tender site over the lateral epicondyle. Pre - injection VAS, Nirschl grading, qDASH9 score, radiograph of elbow AP/LATERAL, and hematological investigation (CBC, Coagulation profile) were recorded. Results: A total of 45 patients were enrolled in this study out of which 16 patients (35.56 %) were in between 31 to 40 years age group which was more prevalent and the minimum and maximum age was 18 and 63 years respectively.20 (44.44%) were males and 25 (55.56%) were females. Mean VAS before PRP injection, after 3 weeks, 3 months and 6 months were 6.57 ? 1.30, 4.68 ? 1.09, 2.82 ? 1.06, 1.72 ? 1.04 respectively, Mean nirschl before PRP injection, after 3 weeks, 3 months and 6 months were 5.37 ? 0.94, 3.66 ? 0.84, 2.13 ? 0.74, 1.55 ? 0.71 respectively, and Mean qdash9 scores before PRP injection, after 3 weeks, 3 months and 6 months were67.65 ? 13.04, 48.76 ? 9.49, 32.39 ? 9.43, 17.58 ? 9.22 respectively, which were significantly improved in the follow up. Conclusion: It could be concluded that Intra - tendinous PRP injections at the most tender site in patients of lateral epicondylitis is a valid treatment option. Single injection of PRP is as effective as multiple injections and more efficacious than steroid in treatment of lateral epicondylitis. The limitation of this study are small study group, absence of a control, short term follow up, no sonographic evaluation was done.
Keywords: Platlet Rich Plasma, Corticosteroid Injection, Lateral Epicondylitis
Edition: Volume 12 Issue 7, July 2023,
Pages: 1668 - 1671