Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial.

Abstract

OBJECTIVES:

To determine the efficacy of platelet-rich plasma (PRP) compared to lidocaine as a tenotomy adjuvant for people with elbow tendinopathy.

METHODS:

Our study was a parallel-group, double-blind, randomized trial involving 71 patients with recalcitrant elbow tendinopathy who received two sessions of ultrasound-guided tenotomy with either PRP or lidocaine in a tertiary public hospital. The primary end point was the percentage of patients with an improvement exceeding 25% reduction in disability (Spanish version of the Disabilities of the Arm, Shoulder and Hand questionnaires-DASH-E) at 6 and 12 months; the secondary outcome was the percentage of patients exceeding 25% reduction in pain (VAS-P).

RESULTS:

There was no evidence of significant differences in the proportion of patients who experienced clinically relevant improvements. After 6 months, 18 patients (78.59%) in the lidocaine group and 19 patients (73.08%) in the PRP group showed improved function above 25% (unadjusted odds ratio, 0.90; 95% confidence interval [CI], 0.90 (0.17 to 4.60)); 21 patients (72.21%) in the lidocaine group versus 22 patients (84.62%) in the PRP group achieved more than 25% pain reduction (unadjusted odds ratio, 0.48; 95% CI, 0.10 to 2.37). After 12 months, 17 patients (70.83%) in the lidocaine group versus 19 patients (76%) in the PRP group had improved function (unadjusted odds ratio, 0.71; 95% CI, 0.13 to 3.84), and 19 patients (76%) in the lidocaine group versus 20 patients (90.91%) in the PRP group had improved pain above 25% (unadjusted odds ratio, 0.35; 95% CI, 0.06 to 2.51). Hypercholesterolemia and baseline vascularization influenced outcomes. There were no differences between groups in the adjusted odds ratios.

CONCLUSION:

PRP results in similar improvements to those obtained with lidocaine. Selecting patients according to their pretreatment status can improve treatment efficacy.

TRIAL REGISTRATION:

NCT01945528 , EudraCT 2013-000478-32. Registered 18 August 2013, enrolment of the first participant 10 March 2014.

• Authors: Jose Ignacio Martin, Leire Atilano, Josu Merino, Igor Gonzalez, Gotzon Iglesias, Luis Areizaga, Paola Bully, Gonzalo Grandes, Isabel Andia
• Journal: Journal of orthopaedic surgery and research (J Orthop Surg Res) Vol. 14 Issue 1 Pg. 109 (Apr 23 2019) ISSN: 1749-799X [Electronic] England
• PMID: 31014382 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anesthetics, Local
• Lidocaine

Topics

• Adult
• Anesthetics, Local (administration & dosage)
• Double-Blind Method
• Female
• Humans
• Lidocaine (administration & dosage)
• Male
• Middle Aged
• Platelet-Rich Plasma
• Tennis Elbow (diagnostic imaging, drug therapy, surgery)
• Tenotomy (methods)
• Ultrasonography, Interventional (methods)