Local injection of autologous platelet rich plasma and corticosteroid in treatment of lateral epicondylitis and plantar fasciitis: Randomized clinical trial (original) (raw)
Related papers
2018
Background: Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle-aged patients that is associated with local tendon pathology, alteration in pain perception and motor impairment. Several approaches to treatment have been proposed, the most frequently used is PRP. Platelet-rich plasma (PRP) is a growing modality for tissue healing, regeneration and has more pain relief lasting effect. Aim of the work: was to estimate the clinical efficacy of local injection of Platelet Rich Plasma compared to local injection of corticosteroids in cases of lateral epicondylitis. Patients and Methods: This study was a prospective clinical trial study in which 80 patients with lateral epicondylitis of both sexes between 2l - 60 years of age were recruited for the study. The included patients were divided into two groups: 1- Platelet Rich Plasma group (40 patients) were received a two injections of 1 ml of PRP with one month interval between the ...
International Journal of Research in Orthopaedics, 2017
Many treatment options are available like use of NSAIDS, steroid injections, physiotherapy but all these have short term relief. 2,3 Now-a-days, injections of platelet rich plasma (PRP) was proved to be efficacious ABSTRACT Background: Lateral epicondylitis is seen more commonly in non-athletes than athletes. Non-operative methods are the mainstay of treatment being effective in more than 95% of cases. Platelet rich plasma (PRP) has shown promising results in many studies as compared to steroid injection & other modes of conservative management. Hence, this study was done to evaluate PRP efficacy in our clinical setup and in the people of age group most commonly being affected. Methods: This randomized study was conducted at Narayana Medical College Hospital, Nellore, for a period of two years from December 2014 to June 2016 on 150 consenting patients diagnosed as suffering from lateral epicondylitis. Using lottery method for randomization the patients were divided into three groups, based on which the treatment was received. Group-N with 50 patients received 3 ml of normal saline as placebo. Group-P with 50 patients received 3 ml of extracted PRP injection. GroupS with 50 patients received depot preparation of 40 mg of methyl prednisiolone injected into the affected area. The data collected and recorded in the appropriate proforma. Post therapy assessment was done using with Oxford elbow score. Results: The overall mean ages of the patients in the three groups (Group P, Group S and Group N) are 38.62±7.53, 37.82±7.79 and 36.3±6.93 respectively. Female preponderance was observed in all the groups. Most common presenting complaint was elbow pain seen in 100% of cases. Most common side involved was the dominant side, right side involvement was seen in 136 cases and left side in 14 cases. The Oxford elbow score pre-treatment in all the groups was not statistically significant and the Oxford elbow score at the end of 12 weeks and 24 weeks treatment showed that PRP and steroid was better than normal saline in control of pain. Conclusions: Lateral epicondylitis or tennis elbow is a painful debilitating condition of elbow, which creates disturbance in functional activities. A single injection of PRP at the site of the elbow pain resulted in relief of pain in patients with longer duration as compared to local steroids to other conservative treatments.
The aim of the study was to access effectiveness of corticosteroid injections and Platelet rich plasma (PRP) injections in treatment of lateral epicondylitis using visual analogue scale (VAS), Disability of arm, shoulder and hand (DASH) score, painfree grip strength. Our study was conducted on 60 patients who attended orthopaedic opd with lateral epicondylitis which were randomly assigned to PRP group (n=30) and corticosteroid group (n=30). Patients were followed up for two years. Success was defined as a 25% reduction in VAS or DASH score and 25% increase in painfree grip strength. Both groups significantly improved across time. When baseline VAS, DASH score and painfree grip strength were compared with scores at two year followup, the DASH score and painfree grip strength of corticosteroid group was returning to baseline scores, while those of PRP group significantly improved. The PRP group was more often treated successfully than the corticosteroid group (p<0.0001). There was no complication related to the use of PRP. Therefore to conclude that treatment of patient with lateral epicondylitis with PRP reduces pain and increases function significantly and is more effective than corticosteroid injections.
Pakistan Armed Forces Medical Journal, 2020
Objective: To compare platelet rich plasma against local steroid injection in patients with chronic plantar fasciitis in terms of mean pain and functional scores. Study Design: Quasi-experimental study. Place and Duration of study: Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi, from May 2016 to Apr 2018. Methodology: A total of 120 patients having chronic plantar fasciitis were included in the study and were split into 2 groups. The group “A” (n=60) patients were injected with a single dose of autologous platelet rich plasma. The group “B” (n=60) patients received a single dose of methylprednisolone added with a local anesthetic agent. Functional and symptomatic evaluation was done using the American foot and ankle score and the visual analog scale respectively at baseline and at 6 months follow-up. Results: Mean visual analogue score was 7.83 ± 0.99 at baseline and 3.43 ± 1.30 at 6 months follow-up in group “A” and 7.90 ± 1.06 and 4.97 ± 1.16, respectively, i...
International Surgery Journal, 2019
Background: Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. The primary objective of the study was to evaluate and compare the effectiveness of autologous platelet rich plasma (PRP) and steroid injections in chronic cases of plantar fasciitis (PF).Methods: A prospective, randomized study was conducted from December 2013 to December 2015 amongst 60 patients with chronic PF were randomized prospectively in single tertiary care center in India. All the patients were enrolled according to inclusion criteria and divided into 2 groups i.e. group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Roles and Maudsley score (RM Score) and Foot Function Index (FFI) was evaluated for all the included patients. The follow-up scheduled at 1 and 6 months after complete enrolm...
The American Journal of Sports Medicine, 2011
Background: Platelet-rich plasma (PRP) has been shown to be a general stimulation for repair and 1-year results showed promising success percentages. Purpose: This trial was undertaken to determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis with a 2-year follow-up. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: The trial was conducted in 2 Dutch teaching hospitals. One hundred patients with chronic lateral epicondylitis were randomly assigned to a leukocyte-enriched PRP group (n = 51) or the corticosteroid group (n = 49). Randomization and allocation to the trial group were carried out by a central computer system. Patients received either a corticosteroid injection or an autologous platelet concentrate injection through a peppering needling technique. The primary analysis included visual analog scale (VAS) pain scores and Disabilities of the Arm, Shoulder and Hand (DASH) outcome scores. ...
Healthcare
Background: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. Method: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of the following: PRP, steroids, or autologous blood injections. Thereafter, VAS (visual analog scale), DASH (Disabilities of the Arm, Shoulder, and Hand), and Nirschl scores of those treated were evaluated in the second week, the fourth week, the third month, and the sixth month. Results: The baseline evaluation revealed no significant change in VAS, DASH, and Nirschl scores among the three groups (p > 0.050). At the second week evaluation, patients treated with steroids showed significant improvement compared to patients treated with PRP and autologous blood (p < 0.001). The fourth-week evaluation revealed the VAS, DASH, and Nirschl scores of the patients treated with steroids to have improved more significantly than t...
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
The aim of the study was to evaluate the efficacy of local injection of platelet rich plasma in management of patients with tennis elbow who failed to respond to conservative management. Methods: This was a prospective and cohort study in which 80 patients with lateral epicondylitis (Tennis elbow) were included on the basis of a predefined inclusion and exclusion criteria. Demographic details were noted. Patients were treated by local injection of autologous platelet rich plasma. Patients were followed up for 6 months. Relief of pain as well as functional improvement was assessed by patient-rated tennis elbow evaluation (PRTEE) score. SSPS 21.0 software was used for statistical analysis and p<0.05 was taken as statistically significant. Results: Out of 80 studied cases, there were 36 (45%) males and 44 (55%) females with a M: F ratio of 1:1.22. The mean age of male (42.77±9.95 years) as well as female (41.06±9.56 years) was found to be comparable. Nineteen (23.75%) patients were involved in plumbing, 16 (20%) patients were involved in activities that required forceful use of screwdrivers such as electric work, 8 (10%) patients were involved in gardening, and 7 (8.75%) patients were involved in production or laying of bricks. Twelve (15%) patients were professional tennis player. The mean PRTEE score was 74.24±9.74 at the time of presentation. There was significant reduction in PRTEE score during follow-up and at the time of last follow-up visit, PRTEE score was found to be 8.32±2.56. Conclusion: Local injection of autologous platelet rich plasma is effective in managing patients of lateral epicondylitis (Tennis elbow) who fail to respond to conservative management.
IOSR Journals , 2019
Tennis elbow is the most common cause of elbow pain in patients attending the orthopaedic clinics. Pathophysiology involves micro tears in the tendon leading to haemorrhage, rough granulation tissue formation and later repair.. Even though the different treatment modalities of tennis elbow have been claimed to be effective in treating this condition due to its chronic nature and tendency to recur with resumption of activity, no single modality has been considered. Platelet-rich plasma prolotherapy (PRPP) is an injection treatment that has been used in recent times for various enthesopathies. It repairs incompletely healed injuries thereby reducing pain and increasing function. Our study aims to compare the efficacy of PRPP and compare it with the more traditionally used steroid in the population of this part of the country. This based randomized, prospective, interventional study was conducted on patients of lateral epicondylitis visiting our OPD. A total of 200 patients were included in the study. Improvement in the PRP injection group was significantly greater than that in the corticosteroid injection group (P<0.001). From this study it was concluded that both local corticosteroid and PRP injection therapy are simple outdoor procedures for the treatment of lateral epicondylitis. However, PRP is better in terms of long term relief and very negligible side effects.
Journal of Foot and Ankle Surgery (Asia Pacific)
Introduction: Chronic plantar fasciitis (PF) is the most common cause of foot complaints making up to 11-15% of the foot symptoms requiring professional care among adults. Also, it is a common problem that affects sport participants as well as inactive middle-aged individuals. The purpose of this study was to compare the effect of steroid and platelet-rich plasma (PRP) in chronic PF. The results were assessed by comparing American orthopedic foot and ankle scale (AOFAS) and visual analogue scale (VAS) before injection, 1, 2, and 6 months after injection in both groups comprising 25 patients in each group. Results: In our study of 50 patients, in steroid group-A, there is significant change in mean VAS from 6.28 ± 0.86 before follow-up injection to 2.8 ± 0.76 in first follow-up visit (1 month after injection) and to 2.92 ± 0.75 in second follow-up visit (2 months after 1st injection) and remained constant at 2.92 + 0.75 at third follow-up (6 months post 1st injection) and significant change in mean AOFAS from 67 ± 10 before injection to 85.76 ± 5.44 in first follow-up visit (1 month after injection) and to 84.16 + 5.94 in second follow-up visit (2 months after first injection) and deteriorated further to 83.92 + 5.84 at third follow-up (6 months after first injection). In 25 patients in group B, there is significant change in mean VAS from 5.8 ± 80.78 before follow-up injection to 1.96 ± 0.45 in first follow-up visit (1 month after injection) and to 1.96 ± 0.45 in second follow-up visit (2 months after first injection) and remained constant at 1.96 ± 0.45 at third follow-up (6 months post first injection) and significant change in AOFAS from 68.44 ± 17.78 before injection to 89.56 ± 0.91 in first follow-up visit (1 month after injection) and to 89.84 ± 0.55 in second follow-up visit (2 months after first injection) and improved further to 89.92 ± 0.40 at third follow-up (6 months after first injection). Conclusion: PRP injection is more effective than corticosteroid injection in the treatment of chronic PF in the long run.