PRP and Prolotherapy Yield Superior Long-Term Outcomes in Chronic Lateral Epicondylosis
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Comparing the Use of Physiotherapy, Shockwave Therapy, Prolotherapy, and Platelet-Rich Plasma for Chronic Lateral Epicondylosis: A Prospective, Randomized Controlled Trial With 2-Year Follow-up.
Am J Sports Med . 2025 Sep;53(11):2707-2714.Two hundred thirty-one patients with chronic lateral epicondylosis were randomized to physiotherapy (n=58), extracorporeal shockwave therapy (ESWT) (n=62), prolotherapy (n=56), or platelet-rich plasma (PRP)(n=55). The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH); the secondary outcome was a 6-point Subjective Satisfaction Score (SSS). Outcomes were assessed at baseline, 3, 6, 18, and 24 months, with 24 months pre-specified as primary. Overall, the results of the study revealed that PRP achieved the largest DASH improvement at 24 months (−31.18) and the highest SSS (4.60±0.90), with prolotherapy also outperforming physiotherapy and ESWT on both outcomes; all groups exceeded the DASH MCID. These findings suggest PRP and prolotherapy are effective non-surgical options with durable 2-year benefits in longstanding disease.
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