This double-blind RCT randomized 60 adults with chronic lateral epicondylitis to a single injection of PRP, glucocorticoid, or saline placebo. The primary endpoint was pain reduction on the PRTEE at 3 months. Ultrasound changes in tendon thickness and color Doppler activity were secondary outcomes.
The clinical rule here is straightforward: for chronic lateral epicondylitis, a single injection of PRP or glucocorticoid offers no durable advantage over saline placebo. Glucocorticoid buys short-term relief at about 4 weeks, but that benefit disappears by 3 months and carries real risks (skin atrophy occurred in 3 of 20 patients here).
This was the first PRP trial in lateral epicondylitis to include a genuine saline placebo arm, which matters for critical appraisal. Earlier positive PRP trials (Peerbooms, Mishra) compared PRP against glucocorticoid or bupivacaine, not placebo, so they could not separate true drug effect from needling and natural history.
A teaching point worth memorizing: glucocorticoid dramatically improved the ultrasound picture (Doppler cleared in 90%), yet this did not translate into lasting pain relief. Imaging response is not the same as clinical response. Weigh the evidence carefully though, the trial had massive dropout after 3 months, so long-term conclusions are weak, and any late-onset PRP effect could have been missed.
This double-blind RCT randomized 60 adults with chronic lateral epicondylitis to a single injection of PRP, glucocorticoid, or saline placebo. The primary endpoint was pain reduction on the PRTEE at 3 months. Ultrasound changes in tendon thickness and color Doppler activity were secondary outcomes.
The clinical rule here is straightforward: for chronic lateral epicondylitis, a single injection of PRP or glucocorticoid offers no durable advantage over saline placebo. Glucocorticoid buys short-term relief at about 4 weeks, but that benefit disappears by 3 months and carries real risks (skin atrophy occurred in 3 of 20 patients here).
This was the first PRP trial in lateral epicondylitis to include a genuine saline placebo arm, which matters for critical appraisal. Earlier positive PRP trials (Peerbooms, Mishra) compared PRP against glucocorticoid or bupivacaine, not placebo, so they could not separate true drug effect from needling and natural history.
A teaching point worth memorizing: glucocorticoid dramatically improved the ultrasound picture (Doppler cleared in 90%), yet this did not translate into lasting pain relief. Imaging response is not the same as clinical response. Weigh the evidence carefully though, the trial had massive dropout after 3 months, so long-term conclusions are weak, and any late-onset PRP effect could have been missed.