Brian Halpern, Salma Chaudhury, Joseph Nguyen, Catherine Hayter and Landon Hough
Back Ground: Platelet Rich Plasma is now being utilized for patients with tendinosis and arthritis. This treatment option in many instances has replaced the need for surgery.
Hypothesis: The purpose of this study was to investigate if Platelet Rich Plasma (PRP) treatment of elbow tendinosis is associated with improved clinical outcomes with respect to pain, function and return to sports/ recreation. Also to determine if an MRI would detect any significant structural changes of the tendon after treatment.
Study Design: Prospective case series, Level of Evidence: IV
Methods: This study evaluated 114 patients treated with PRP for either lateral or medial elbow tendinosis. Tendinopathy was confirmed with a baseline MRI in all patients. Subjects completed serial visual analog scales (VAS) to assess pain, elbow function and sports/recreational activity levels at 6 and 12 months post-injection. An additional retrospective score was recorded approximately 24 months post-injection. 17 patients had post-treatment MRIs between 6 months and 1 year to assess healing.
Results: The average age of patients was 51.9 years with 43% (49) females and 57% (65) males. Extensor Tendinosis was diagnosed in 65% (74) and flexor tendinosis in 35% (40) patients. VAS pain scores at 6 months were reduced significantly (61%) and at 1 year (69%) from baseline, with a 2 year (83%) reduction (p<0.001). Functional scores at 6 months increased significantly (64%) at 6 months and at 1 year (76%) from baseline with maintenance at 2 years of a (77%) improvement (p<0.001)). Sports/recreational level scores at 6 months increased significantly (81%) and at 1 year (165%) from baseline, with a 2 year (107%) improvement (p<0.001). No differences in outcomes were noted between medial versus lateral tendinosis. MRI in a limited number of patients compared to baseline demonstrated an improvement in the appearance of tendinosis (47.19%) and partial tears (44%).
Conclusion: PRP treatment for lateral or medial elbow tendinosis resulted in significant improvements in pain levels, elbow function and sports/recreational activities. This study suggests that PRP may improve clinical outcomes for up to two years.
Clinical Relevance: Yes