The Orthobiologic Institute (TOBI) Founder, Dr. Steve Sampson, Published Study on the Efficacy of Platelet-Rich Plasma for Chronic Tennis Elbow in the American Journal of Sports Medicine:
Dr. Steve Sampson, TOBI founder and annual conference course director, published an article in the American Journal of Sports Medicine titled Efficacy of Platelet-Rich Plasma for Chronic Tennis Elbow. The double-blinded, prospective, multi-center, randomized controlled trial investigated the efficacy of needling with and without unactivated leukocyte-enriched platelet-rich plasma (PRP) in the treatment of chronic lateral epicondylar tendinopathy.
The 230 patients selected for the study presented with greater than 5/10 pain on the visual analog scale (VAS) at the lateral epicondyle for longer than 3 months, and had failed at least one conventional therapy. Patients were randomized into 2 groups, either to receive PRP or to be an active control, with no notable baseline differences between the two groups. The patients were treated at 12 centers over the course of 5 years.
Thirty mL of autologous blood was mixed with anticoagulant (ACD-A) and centrifuged to produce unactivated leukocyte-enriched PRP with platelet a concentration of 5 times baseline. Following local anesthetic at the injection site, the PRP group received 2-3 mL of Platelet Rich Plasma into the extensor carpi radialis brevis tendon and surrounding area using a peppering technique. The active control group was injected with 2-3 mL of bupivacaine using the same technique.
At follow-up, participants in the PRP group reported more improvement in pain scores relative to the active control group, with statistically significant differences at weeks 8 (59.3% vs 41.7%, PRP vs active control) and 24 (71.5% vs 56.1%). The study also revealed differences in local tenderness at each post-treatment follow-up (4, 8, 12, 24 weeks), with significant differences at 24 weeks as 29% of the PRP group and 54% of the active control group reported local tenderness at that point in time. A successful outcome in the study was defined as a 25% or greater improvement in VAS score at 24 weeks as compared to the patient’s baseline report. The PRP group success rate was calculated at 83.9% vs 68.3% in the active control group.
This study adds to a growing volume of literature, including previous randomized controlled trials by Peerbooms et al. as well as Mishra and Pavelko, supporting the use of unactivated leukocyte-enriched PRP (type 1 PRP) for patients with chronic Tennis Elbow. Further research collaboration and high level of evidence studies are needed to examine the potential therapeutic efficacy and mechanism of action of PRP in musculoskeletal injuries such as chronic tendinopathies.
For more of the latest research, protocols, and best practices in regenerative medicine, be sure to attend the 6th Annual TOBI: The Orthobiologic Institute PRP & Regenerative Medicine Symposium with Cadaver Lab June 12-14, 2015 in Las Vegas, www.prpseminar.com. Save $300 OFF Registration with Promo Code: TOBIBLOG.
 J. C. Peerbooms, J. Sluimer, D. J. Bruijn, and T. Gosens, “Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up.,” Am. J. Sports Med., vol. 38, no. 2, pp. 255–62, Feb. 2010.
 T. Pavelko. A Mishra, “Treatment of Chronic Elbow Tendinosis With Buffered Platelet-Rich Plasma,” Am J Sport. Med, vol. 34, pp. 1774–1778.