Best Study On Efficacy of Platelet-Rich Plasma For Chronic Tennis Elbow?

This is a PRP study of 230 patients, led by Allan K. Mishra, MD, one of the pioneers of this therapy.

It's the largest and most specific study I've come across: One group in the study got an actual PRP injection, the other got a “sham injection,” meaning a needle inserted with nothing injected (as a placebo effect control group measure)

“CONCLUSION: No significant differences were found at 12 weeks in this study. At 24 weeks, however, clinically meaningful improvements were found in patients treated with leukocyte-enriched PRP compared with an active control group.”

Here's a fast and easy breakdown of the 24-week results:

Improvements in patient pain scores:

Control group: 56.1% improvement
PRP group: 71.5% improvement

Percentage reporting significant elbow tenderness at 24 weeks:

Control group: 54.0%
PRP group: 29.1%

Success rates for patients at 24 weeks:

Control group: 68.3%
PRP group: 83.9%

It's a meaningful and statistically-significant result, but how excited should one be about it?

The patients who were jabbed by a needle but got no injection improved by an average of at least 50% - Which can be attributed to the placebo effect or the effect of the needle alone. ('Dry Needling' or 'Fenestration' is a technique in and of itself.)

One of the things they point out, is that not all PRP preparations are the same, which might account for some of the variations in the findings of various studies...

(Thousands of studies have been done on PRP according to this article in NPR: http://www.npr.org/sections/health-shots/2014/06/11/320971966/platelet-rich-plasma-therapy-gains-fans-but-remains-unproven )

“Some preparations contain only concentrated platelets in a small volume of plasma. Others contain various concentrations of platelets and white blood cells.”

I'm still not sure what to make of this explosion of PRP (and ABI) therapy popularity. I like the theory, but I would like to see a lot more studies. This is a step in the right direction though.

(Almost done with my full-length post on this topic coming later today or tomorrow.)

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