Share This Article:

Treatment of Chronic Lateral Epicondylitis: Platelet Rich Plasma versus Extra-Corporeal Shock Wave Therapy

Abstract Full-Text HTML XML Download Download as PDF (Size:225KB) PP. 77-83
DOI: 10.4236/ojo.2014.43013    7,230 Downloads   9,138 Views   Citations

ABSTRACT

Background: Several treatment options have been proposed to treat lateral epicondylitis. Both Platelet rich plasma (PRP) and Extra-corporeal Shock Wave Therapy (ESWT) are new treatment modalities for tendinopathy. Patients and Methods: Thirty seven patients suffering from chronic lateral epicondylitis (tennis elbow) for at least six months were treated in this study. The patients were divided into two treatment groups, the first group including 20 patients treated by ESWT and the second group including 17 patients treated by local injection of platelet-rich plasma. The results were evaluated using the visual analogue scale and the DASH score. Results: In the first group (treated by ESWT), the average follow-up period was 21.55 months. The average VAS improved from 8.2 to 1.95 and the average DASH score improved from 72.25 to 51.7. Moreover, 11 cases were satisfied (55%), 3 cases (15%) were satisfied with reservation and 6 cases (30%) were not satisfied. In the second group (treated by PRP), the average follow-up period was 18.47 months. The average VAS improved from 8.52 to 1.47, the DASH score improved from 72 to 48.23. Concerning patient satisfaction, 13 cases were satisfied (83.33%), 3 cases (10.52%) were satisfied with reservation and 1 case (5.55%) was not satisfied. Conclusion: Platelet rich plasma was proved to achieve superior results when compared to ESWT as regards pain relief, improvement of elbow function and patient satisfaction at follow-up.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Othman, A. (2014) Treatment of Chronic Lateral Epicondylitis: Platelet Rich Plasma versus Extra-Corporeal Shock Wave Therapy. Open Journal of Orthopedics, 4, 77-83. doi: 10.4236/ojo.2014.43013.

References

[1] Nirschel, R.P. and Pettrone, F.A. (1997) The Surgical Treatment of Lateral Epicondylitis. The Journal of Bone & Joint Surgery, 61, 832-839.
[2] Taylor, S.A. and Hannafin, J.A. (2012) Evaluation and Management of Elbow Tendinopathy. Sports Health: A Multidisciplinary Approach, 4, 384.
[3] Vicenzino, B. and Wright, A. (1996) Lateral Epicondylagia. Epidemiology, Pathophysiology, Etiology and Natural History. Physical Therapy Reviews, 1, 23-34.
http://dx.doi.org/10.1179/ptr.1996.1.1.23
[4] Coonrad, R.W. and Hooper, W.R. (1973) Tennis Elbow: Its Natural Course, Natural History, Conservative and Surgical Management. JBJS, 55A, 1177-1182.
[5] Price, R., Sinclair, H., Heinrich, I. and Gibson, T. (1991) Local Injection Treatment of Tennis Elbow; Hydrocortisone, Triamnicinolone and Lidocaine Compared. British Journal of Rheumatology, 30, 39-44.
http://dx.doi.org/10.1093/rheumatology/30.1.39
[6] Andres, B.M. and Murrel, G.A. (2008) Treatment of Tendinopathy: What Works, What Doesn’T and Is on the Horizon. Clinical Orthopaedics and Related Research, 466, 1539-1554.
[7] Alsousou, J., Thompson, M., Hulley, P., Nobel, A. and Wlett, K. (2009) The Biology of Platelet-Rich Plasma and Its Application in Trauma and Orthopedic Surgery: A Review of the Literature. The Journal of Bone & Joint Surgery, Br., 91, 987-996.
http://dx.doi.org/10.1302/0301-620X.91B8.22546
[8] Scher, D.L., Wolf, J.M. and Owens, B.D. (2009) Lateral Epicondylitis. Orthopedics, 32, 276-281.
http://dx.doi.org/10.3928/01477447-20090401-06
[9] Haupt, G. (1997) Review Article: Use of Extracorporeal Shock Waves in the Treatment of Pseudoarthrosis, Tendinopathy, and Other Therapeutic Cases. Journal of Urology, 158, 4-11.
http://dx.doi.org/10.1097/00005392-199707000-00003
[10] Schelling, G., Delius, M., Gscwender, M., Grafe, P. and Gambihler, S. (1994) Extra-Corporeal Shock Waves Stimulate Frog Sciatic Nerves Indirectly via a Cavitation Mediated Mechanism. Biophysics, 66, 133-140.
[11] Wang, C., Huang, H.Y. and Pai, C.H. (2002) Shock Wave-Enhanced Neovascularization at the Tendon Bone Junction: An Experiment in Dogs. Journal of Foot and Ankle Surgery, 41, 16-22.
http://dx.doi.org/10.1016/S1067-2516(02)80005-9
[12] Creaney, L., Wallace, A., Curtis, M and Conell, D. (2011) Growth Factor-Based Therapies Provide Additional Benefit beyond Physical Therapy in Resistant Elbow Tendinopathy: A Prospective, Single Blind Randomized Trial of Autologous Blood Injections versus Platelet-Rich Plasma Injections. British Journal of Sports Medicine, 45, 966-971.
http://dx.doi.org/10.1136/bjsm.2010.082503
[13] Mishra, A. and Pavelko, T. (2006) Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma. American Journal of Sports Medicine, 34, 17774-17778.
http://dx.doi.org/10.1177/0363546506288850
[14] Peerbooms, J.C., Sluimer, J., Bruijn, D.J. and Gosens, T. (2010) Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis in a Double-Blind Randomized Controlled Trial: Platelet-Rich Plasma versus Corticosteroid Injection with a 1year Follow-Up. American Journal of Sports Medicine, 38, 255-262.
http://dx.doi.org/10.1177/0363546509355445
[15] Mishra, A., Randelli, P., Barr, C., Talamonti, T., Raone, V. and Cabitza, P. (2012) Platelet-Rich Plasma and the Upper Extremity. Hand Clinics, 28, 481-491.
http://dx.doi.org/10.1016/j.hcl.2012.08.008
[16] Chaudhury, S., de lama, M., Alder, R.S., Gultta, L.V., Skonieczki, B., Moley, P., Cordasco, E., Hannafin, J. and Fealy, S. (2012) Platelet-Rich Plasma and the Upper Extremity. Skeletal Radiology, [Epub ahead of print].
[17] Rompe, J.D., Hopf, C., Kullmer, K., Heine, J. and Burger, R. (1996) Analgesic Effect of Extracorporeal Shock Wave Therapy on Chronic Tennis Elbow. The Journal of Bone & Joint Surgery, 78, 233-237.
[18] Haake, M., Koni, I.R. and Decker, T. (2002) No Effectiveness of Extracorporeal Shock Wave Therapy in the Treatment of Tennis Elbow: Results from Prospective Randomized Placebo-Controlled Multicenter Trial. The Journal of Bone & Joint Surgery, 84-A, 1982-1991.
[19] Pettrone, F.A. and McCall, B.R. (2005) Extracorporeal Shock Wave Therapy without Local Anesthesia for Chronic Lateral Epicondylitis. The Journal of Bone & Joint Surgery, 87-A, 1297-1304.
http://dx.doi.org/10.2106/JBJS.C.01356
[20] Staples, M.P., Forbes, A. and Patznik, R. (2008) A Randomized Controlled Trial of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis. Journal of Rheumatology, 35, 2038-2046.
[21] Hechtman, S., Uribe, J., Bottovan Demden, A. and Kiebzak, G.M. (2011) Platelet-Rich Plasma Injection Reduces Pain in Patients with Recalcitrant Epicondylitis. Orthopedics, 34, 2-92.
[22] Thanasas, C., Papadimtriou, G., Charalambidis, C., Paraskevopouols, I. and Papanikolau, A. (2011) Platelet Rich Plasma versus Autologous Blood for the Treatment of Chronic Lateral Elbow Epicondylitis: A Randomized Controlled Trial. American Journal of Sports Medicine, 39, 2134-2134.
http://dx.doi.org/10.1177/0363546511417113
[23] Gosens, T., Peerbooms, J.C., van Laar, W. and den Oudsten, B.L. (2011) Ongoing Positive Effect of Platelet Rich Plasma versus Corticosteroid Injection in Lateral Epicondylitis: A Double-Blind Randomized Controlled Trial: Platelet-Rich Plasma versus with 2 Years Follow-Up. American Journal of Sports Medicine, 39, 1200-1208.
http://dx.doi.org/10.1177/0363546510397173

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.