A Randomized Controlled Trial of 1-Year Clinical Outcomes of a Single Platelet-Rich Plasma Injection Versus Corticosteroid for the Treatment of Lateral Elbow Tendinopathy

Background: Platelet-rich plasma (PRP) treatment for chronic lateral elbow tendinopathy (LET) has increased because of its potential for prolonged symptom relief and improved function. Limited studies have definitively documented long-term benefits. Purpose: To assess the efficacy of a single intratendinous PRP injection compared to a corticosteroid injection for the treatment of LET. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In total, 48 participants (n = 50 elbows), aged 18 to 65 years, were randomly assigned to ultrasound-guided PRP (n = 26) or corticosteroid (control, n = 24) injection. Patient-Rated Tennis Elbow Evaluation (PRTEE) and Quick version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) were compared at baseline and 4, 8, 12, 16, 26, and 52 weeks. Secondary outcomes were assessed via grip strength, visual analog scale (VAS) scores, and overall satisfaction with treatment. Wilcoxon rank-sum tests and longitudinal analysis of covariance models were used to assess outcomes over time. Results: At 4 weeks, mean PRTEE scores were 47.6 ± 3.7 in the PRP group compared to 14.8 ± 3.9 in the CSI group ( P < .001). At 8 weeks, PRTEE scores were 32.1 ± 3.7 for PRP and 15.2 ± 4.0 for CSI ( P = .003). At 12 weeks, scores were 26.3 ± 3.9 for PRP versus 16.0 ± 4.1 for CSI ( P = .07). By 26 weeks, mean scores favored PRP (17.7 ± 6.5 vs 35.3 ± 6.8; P = .07), and by 52 weeks, PRP scores remained lower (14.4 ± 6.3 vs 29.6 ± 6.3; P = .10). At 4 weeks, mean QuickDASH scores were 22.4 ± 1.1 in the PRP group versus 15.5 ± 1.1 in the CSI group ( P < .001). At 8 weeks, PRP scores were 19.3 ± 1.1 compared to 15.8 ± 1.2 for CSI ( P = .04). No significant differences were observed at 12 weeks (17.7 ± 1.1 vs 16.6 ± 1.2; P = .49) or 16 weeks (16.8 ± 1.1 vs 18.4 ± 1.2; P = .35). At 26 weeks, QuickDASH scores favored PRP (15.7 ± 1.6 vs 20.3 ± 1.7; P = .05), and this difference persisted at 52 weeks (14.0 ± 1.6 vs 18.6 ± 1.6; P = .05). However, VAS scores were on average 1.5 points lower in the PRP group across all time points. Conclusion: Our study demonstrated that corticosteroids resulted in greater short-term improvement, while PRP demonstrated superior longer-term outcomes at 6 and 12 months. PRP was associated with lower average VAS scores over time.