Under the direction of Dr. Taco Gosens from the Netherlands, a prospective, randomized, controlled trial of 100 patients was done to evaluate the efficacy of platelet rich plasma against cortisone for chronic tennis elbow. They recently reported their results in the American Journal of Sports Medicine. (Feb. 2010)
73% of the PRP treated patients were successful compared to 51% in the corticosteroid group (p < 0.001) at one year of follow up according to visual analog pain and functional scores. This represents a 43% better success rate for PRP. This data should put to end the option of using cortisone for chronic tennis elbow. There is only limited support for its use in short term pain relief. It is also clear from these last two papers that the evaluation of PRP must be done by specific clinical problem and the severity of the problem. Only by doing careful studies we will be better able to predict which patients will respond to PRP as a therapy.
Finally, PRP in my opinion should be reserved for patients that have failed non-operative treatment and are considering surgery. Most patients with tendinopathy will respond without invasive intervention. A study directly comparing PRP to surgical outcomes for tendinopathy should be considered.
AM
Total Tendon
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Tuesday, February 02, 2010
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