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New biologic treatment for tennis elbow may replace surgery for chronic sufferers

patients who had tennis elbow for longer than 3 months and had scored at least a 60 of 100 using a visual analog scale (a continuum on which a person rates the severity of his/her pain: 0 = no pain; 100 = maximum pain). They all had completed a course of physical therapy and had tried some combination of anti-inflammatory medicines, bracing or cortisone shots, all without relief of symptoms. Twenty of the original 140 patients evaluated met these strict criteria and were enrolled in the study. These 20 represented the most severe tendonitis patients who had not improved with time or nonsurgical treatment.

Fifteen patients received a one-time injection of platelet-rich plasma (PRP) into their affected elbow. (Platelets are blood components responsible for the formation of clots in response to injury, but also contain powerful growth factors; plasma is the liquid portion of the blood.) Blood was drawn from a patient's unaffected arm and spun down in the physician's office lab to separate the blood's components. Approximately a half-teaspoon (2 to 3 mL) of this material ?over 500% richer in platelets than whole blood ?was then injected into the tendon of the sore elbow. These 15 patients had tennis elbow for 15 months and the average patient age was 48 years. Their baseline score on the pain scale was 80.3.

Five patients served as a control (non-PRP) group and received a 2 to 3 mL injection of a local anesthetic (bupivacaine with epinephrine) into the affected elbow. The mean duration of symptoms in this group was 12 months and average patient age was 42 years. Their baseline score on the pain scale was 86.

Twenty-four hours post-treatment both groups began a 2-week standardized stretching program and at 4 weeks patients were allowed to return to normal sporting and recreational activities. Follow-up visits were planned at 4 weeks, 8 weeks and 6 months post-treatment, with a final overall evaluation. Using the visual analog scale
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Source:American Orthopaedic Society for Sports Medicine


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