DM do you have the reference for the article where the PRP subjects did better, would like to read that as well.
Just attended the AIUM MSK US course at Mayo which was fantastic. Lots of discussion re: PNT, PRP, steroid, prolo. No clear concensus as of yet but very interesting times for MSK medicine.
Here you go. Small pilot study, but interesting results.
1: Am J Sports Med. 2006 Nov;34(11):1774-8. Epub 2006 May 30.
Treatment of chronic elbow tendinosis with buffered platelet-rich plasma.
Mishra A, Pavelko T.
Department of Orthopedic Surgery, Menlo Medical Clinic, Stanford University
Medical Center, 1300 Crane Street, Menlo Park, CA 94025, USA.
[email protected]
BACKGROUND: Elbow epicondylar tendinosis is a common problem that usually
resolves with nonoperative treatments. When these measures fail, however,
patients are interested in an alternative to surgical intervention. HYPOTHESIS:
Treatment of chronic severe elbow tendinosis with buffered platelet-rich plasma will reduce pain and increase function in patients considering surgery for their problem. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: One hundred forty patients with elbow epicondylar pain were evaluated in this study. All these patients were initially given a standardized physical therapy protocol and a variety of other nonoperative treatments. Twenty of these patients had significant persistent pain for a mean of 15 months (mean, 82 of 100; range, 60-100 of 100 on a visual analog pain scale), despite these interventions. All patients were considering surgery. This cohort of patients who had failed nonoperative treatment was then given either a single percutaneous injection of platelet-rich plasma (active group, n = 15) or bupivacaine (control group, n = 5). RESULTS: Eight weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement
in control patients (P =.001). Sixty percent (3 of 5) of the control subjects
withdrew or sought other treatments after the 8-week period, preventing further direct analysis. Therefore, only the patients treated with platelet-rich plasma were available for continued evaluation. At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P =.0001). At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P <.0001). CONCLUSION: Treatment of patients with chronic elbow tendinosis with buffered platelet-rich plasma reduced pain significantly in this pilot investigation. Further evaluation of this novel treatment is warranted. Finally, platelet-rich plasma should be considered before surgical intervention.