Role Of Ultrasonographic Evaluation In Comparing The Efficacy Of Corticosteroid And Platelet Rich Plasma In Lateral Epicondylitis

Research Article
Amaresh Kumar Shukla., Alka Agrawal and Amit Shankhwar
DOI: 
http://dx.doi.org/10.24327/ijrsr.2018.0903.1799
Subject: 
science
KeyWords: 
Tennis elbow, lateral epicondylitis, PRP, corticosteroid, ultrasonography.
Abstract: 

Introduction: Lateral epicondylitis is a common musculoskeletal disorder of the common extensor tendon, pathophysiology of which is not well understood. Recently biological agents (PRP) have showed favorable long-term outcome. In this study our aim was to evaluate the changes observed on ultrasonography to stablish the efficacy of autologous PRP Versus Steroid injection in the treatment of chronic lateral epicondylitis. Material and Methods: 72 patients aged 18 to 60 years were diagnosed with lateral epicondylitis. Patients were randomised to receive PRP (n=36) or CS (n=36) injection. Group A patient received 1 ml of local autologous PRP injection whereas; group B patients were injected with 1 ml (40 mg/ml) local methylprednisolone. Ultrasonographic and Clinical parameters including VAS and Oxford elbow score were reassessed in follow up at 2 weeks, 4 weeks, 3 months and 6 months. Result: Ultrasonographic features and clinical parameters including VAS and Oxford elbow score and hand grip strength all improved significantly from pre-injection to the 6-month follow-up in the PRP and CS groups. However, in the CS group, the scores generally peaked at about 3 months and then deteriorated at 6 months indicating recurrence of symptoms. At 6 months, the number of patients positive for ulrasonographic findings generally decreased. Conclusion: Ultrasonography finds a very important role in assessing the lateral epicondylitis and its follow up, this study concludes that PRP appeared to enable long term and biological healing of the lesion, whereas CS appeared to provide short-term, symptomatic relief but resulted in recurrences and tendon degeneration.