Table 2 Details of studies comparing PRP and corticosteroid injections
Reference/ PEDro score Sackett’s Evidence Level | Participants | Methods | Outcome Measures | Results |
|---|---|---|---|---|
Gosens et al. (2011), PEDro = 9 | n = 100 participants PRP group:51, Age: 46.8 ± 8.5 yrs. 23 males, 28 females CS group: 49 Age: 47.3 ± 7.8 yrs. 23 males, 26 females | • Participants received CS injection (one mL with bupivacaine hydrochloride 0.5%) or PRP injection (three mL buffered with 8.4% sodium bicarbonate and bupivacaine hydrochloride 0.5%) • Injections provided in common extensor tendon through a peppering needling technique. • Outcomes assessed at baseline and at 1 month, 2 months, 3 months, 6 months, 1 year and 2 years after the injection. | • VAS • DASH | • CS group had lower pain and improved on DASH scores at 1 month. • No between group changes at 2 months • PRP group had better outcomes at all other assessments. |
Gautam et al. (2015) PEDro = 6 | n = 30 participants PRP group = 15 CS group = 15 No information provided about age or sex distribution | • Injection delivered using peppering technique at most tender point over lateral epicondyle of humerus • Participants received two ml of PRP or 40 mg/ml of methylprednisolone. • Outcomes assessed before and at 2 weeks, 6 weeks, 3 months, and 6 months after injection. • USG was performed before and after injection at three and 6 months | • VAS, • DASH • Oxford Elbow score • Modified Mayo Clinic performance index for elbow, • Hand grip strength | • All outcome measures improved significantly from pre-injection to 6-month retention in both groups. • CS group had greater changes at two- and 6-weeks post-injection. However, the scores of CS group peaked at 3 months and deteriorated at 6 months • No between groups differences present at 3 months • In the CS group, patients with reduced thickness of tendon increased from two to 12. • PRP group had better within group changes in outcomes at 6 months (p < 0.05). |
Yadav et al. (2015) PEDro = 5 | n = 60 participants PRP group: 30 Mean Age: 36.6 yrs. 10 males, 20 females CS group: 30 Mean age: 36.6 yrs. 7 males, 23 females | • Both groups received injection into common extensor origin. • PRP: single injection (one ml), with absolute platelet count of 1 million platelets/ mm3 • CS: single injection of corticosteroid (methylprednisolone, 40 mg in one ml) • Data collected at baseline and 15 days, one and 3 months after injection. | • VAS, • grip strength • qDASH | • CS group had statistically significant and better improvement than PRP group at 15 days and at the 1 month follow assessment. • At end of 3 months, VAS, qDASH and grip strength was significantly better in PRP group (p < .0001). |
Krogh et al. (2013), PEDro = 8 | n = 60 participants: 20 saline, Age: 44.7 ± 7.9 yrs. 9 males, 11 females 20 PRP, Age: 47.6 ± 7.1 yrs. 9 males, 11 females 20 CS Age: 45.4 ± 8.0 yrs. 11 males, 9 females | • Injections provided using an ultrasound-guided, antiseptic peppering technique in the common extensor origin. • The three ml consisted of one ml of triamcinolone (40 mg/ml) and two ml of lidocaine (CS group), three ml of saline or three ml of PRP. • All participants prescribed a standard stretching and training program. • Outcomes assessed at baseline, and at one and 3 months after injection. | • PRTEE • USG changes in tendon thickness • Color Doppler activity | • CS group had maximum reduction in pain and DASH scores at 1 month. Assessment. • All groups improved at 3 months assessment period with no between group differences. • Maximum reduction in tendon thickness and color doppler outcomes in the CS group at 3 months PRP group had greater changes in tendon thickness and Doppler outcomes compared to saline. |