Mishra, Am J Sports Med 2006 - Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma

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Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma

Mishra, Pavelko·Am J Sports Med·2006·909 citations·Retrospective cohort

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Background

Elbow epicondylar tendinosis is a common problem that usually resolves with nonoperative treatments. When these measures fail, however, patients are interested in an alternative to surgical intervention.

Purpose

Hypothesis: Treatment of chronic severe elbow tendinosis with buffered platelet-rich plasma will reduce pain and increase function in patients considering surgery for their problem.

Methods

Study Design: Cohort study; Level of evidence, 2.

140 patients with elbow epicondylar pain were evaluated in this study.
All these patients were initially given a standardized physical therapy protocol and a variety of other nonoperative treatments.
20 of these patients had significant persistent pain for a mean of 15 months (mean, 82 of 100; range, 60-100 of 100 on a visual analog pain scale), despite these interventions.
All patients were considering surgery.
This cohort of patients who had failed nonoperative treatment was then given either a single percutaneous injection of platelet-rich plasma (active group, n = 15) or bupivacaine (control group, n = 5).

Results

8 weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement in control patients (P =.001).
60 percent (3 of 5) of the control subjects withdrew or sought other treatments after the 8-week period, preventing further direct analysis.
Therefore, only the patients treated with platelet-rich plasma were available for continued evaluation.
At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P =.0001).
At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P <.0001).

Conclusions

Treatment of patients with chronic elbow tendinosis with buffered platelet-rich plasma reduced pain significantly in this pilot investigation. Further evaluation of this novel treatment is warranted. Finally, platelet-rich plasma should be considered before surgical intervention.

Copyright remains with the authors and publisher.

Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma.

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Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma

Mishra, Pavelko·Am J Sports Med·2006·909 citations·Retrospective cohort

|

Background

Elbow epicondylar tendinosis is a common problem that usually resolves with nonoperative treatments. When these measures fail, however, patients are interested in an alternative to surgical intervention.

Purpose

Hypothesis: Treatment of chronic severe elbow tendinosis with buffered platelet-rich plasma will reduce pain and increase function in patients considering surgery for their problem.

Methods

Study Design: Cohort study; Level of evidence, 2.

140 patients with elbow epicondylar pain were evaluated in this study.
All these patients were initially given a standardized physical therapy protocol and a variety of other nonoperative treatments.
20 of these patients had significant persistent pain for a mean of 15 months (mean, 82 of 100; range, 60-100 of 100 on a visual analog pain scale), despite these interventions.
All patients were considering surgery.
This cohort of patients who had failed nonoperative treatment was then given either a single percutaneous injection of platelet-rich plasma (active group, n = 15) or bupivacaine (control group, n = 5).

Results

8 weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement in control patients (P =.001).
60 percent (3 of 5) of the control subjects withdrew or sought other treatments after the 8-week period, preventing further direct analysis.
Therefore, only the patients treated with platelet-rich plasma were available for continued evaluation.
At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P =.0001).
At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P <.0001).

Conclusions

Treatment of patients with chronic elbow tendinosis with buffered platelet-rich plasma reduced pain significantly in this pilot investigation. Further evaluation of this novel treatment is warranted. Finally, platelet-rich plasma should be considered before surgical intervention.

Copyright remains with the authors and publisher.

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