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Arthroscopy. 2017 Jul;33(7):1320-1329. doi: 10.1016/j.arthro.2017.02.009. Epub 2017 Apr 19.

Arthroscopic Debridement Versus Platelet-Rich Plasma Injection: A Prospective, Randomized, Comparative Study of Chronic Lateral Epicondylitis With a Nearly 2-Year Follow-Up.

Author information

1
Shoulder and Elbow Unit, "D. Cervesi" Hospital, Cattolica-AUSL della Romagna, Ambito Territoriale di Rimini, Italy; "Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica-AUSL della Romagna, Ambito Territoriale di Rimini, Italy. Electronic address: giovanni.merolla@auslrn.net.
2
"Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica-AUSL della Romagna, Ambito Territoriale di Rimini, Italy.
3
Shoulder and Elbow Unit, "D. Cervesi" Hospital, Cattolica-AUSL della Romagna, Ambito Territoriale di Rimini, Italy.
4
Haematology and Blood Transfusion Unit, "Infermi" Hospital, Rimini-AUSL della Romagna, Ambito Territoriale di Rimini, Italy.
5
Casa di Cura S. M. Maddalena, Occhiobello, Italy.

Abstract

PURPOSE:

The purpose of this prospective, randomized study was to compare the efficacy of autologous platelet-rich plasma (PRP) injections and arthroscopic lateral release in treating chronic lateral epicondylitis (LE).

METHODS:

Patients who had a clinical diagnosis of LE confirmed by ultrasound (US) were included in this study. A total of 101 patients received arthroscopic release (n = 50) or US-guided PRP injections (n = 51). Outcomes were assessed using a visual analog scale for pain, the Patient-Rated Tennis Elbow Evaluation (PRTEE), and a calibrated hand dynamometer for grip strength.

RESULTS:

Both patient groups experienced significant improvement in all measures. Between-group comparisons showed a significantly higher value in the PRP group only for grip strength at week 8 (P = .0073); all other significant differences were in favor of arthroscopy: overall pain (P = .0021), night pain (P = .0013), and PRTEE score (P = .0013) at week 104 and grip strength at weeks 24, 52, and 104 (all P < .0001). Consumption of rescue pain medication was not significantly different between the groups.

CONCLUSIONS:

The present findings suggest that (1) PRP injections and arthroscopic extensor carpi radialis brevis release are both effective in the short and medium term; (2) PRP patients experienced a significant worsening of pain at 2 years; (3) arthroscopic release ensured better long-term outcomes in terms of pain relief and grip strength recovery; and (4) both procedures were safe and well accepted by patients. LEVEL OF EVIDENCE: Level II, prospective comparative study.

PMID:
28433443
DOI:
10.1016/j.arthro.2017.02.009
[Indexed for MEDLINE]

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