AAOS2017: Comparing 12-mo outcomes between PRP and surgery for tennis elbow

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
92 patients with lateral epicondylitis for at least 6 months who were nonresponsive to previous conservative therapies were randomized to either an injection of platelet-rich plasma (PRP) or operative treatment through open debridement/release. Patients were assessed using the Patient-Reported Tennis Elbow Evaluation (PRTEE) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire over a 12-month period. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
PRP injections have been demonstrated to be a safe and effective treatment for lateral epicondylitis when compared to corticosteroid injections. While this treatment appears to be potentially more effective than other injectable treatments, few trials have compared PRP to surgical interventions, hence, the need for this study.
What was the principal research question?
In the treatment of refractory lateral epicondylitis, how do functional outcomes compare between platelet-rich plasma injection and surgical intervention with open debridement when assessed over a 12-month follow-up?
Population: 92 patients with lateral epicondylitis, symptomatic duration longer than 6 months, and who had previous failed conservative management. (n=81 completed the study; Mean age: 47 years))
Intervention: PRP group: Patients were administered platelet-rich plasma injection via a peppering technique. After 4 months, patients who were dissatisfied with their outcome were allowed to crossover and were offered the opportunity to undergo open release/debridement. (n=42)
Comparison: Surgery group: Patients underwent open release/debridement of the extensor carpi radialis brevis. (n=39)
Outcomes: The primary clinical outcome scores were the Patient-Rated Tennis Elbow Evaluation (PRTEE) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.
Methods: RCT
Time: Follow-up was scheduled for 6 weeks, and 3, 6 and 12 months.
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.