Extracorporeal Shock Wave Therapy versus Platelet-rich Plasma Injection for the Treatment of Lateral Epicondylitis: A Prospective Randomized Clinical Trial

Oh, Jeong Hwan; Lhee, Sang Hoon; Park, Jin Young; Choi, Hyeuk Woo; Jeon, Seung Hyub; Eom, Joon Sang

Abstract

PURPOSE
To compare clinical outcomes of extracorporeal shockwave therapy and platelet-rich plasma injection for the treatment of lateral epicondylitis of the elbow.
MATERIALS AND METHODS
Consecutive patients with a lateral epicondylitis who had refractory elbow pain more than 6 months and no response to treatment more than 3 months were recruited for this study. Diagnosis was made on the basis of physical examination and ultrasound imaging study. Prospective randomized trial was performed between two treatment groups; extracorporeal shockwave therapy versus platelet-rich plasma injection. Fifty patients for each group were allocated based on the results of power analysis. Disabilities of arm, shoulder and hand (DASH) scores obtained before treatment and at 1 year after the last treatment were compared between two groups.
RESULTS
Both groups showed significant improvement of DASH scores after treatment. The patients who had platelet-rich plasma injection showed significantly greater improvement of DASH scores (from 37.0 to 11.1) than the patients who had extracorporeal shockwave therapy (from 41.9 to 29.9).
CONCLUSION
Better subjective outcomes can be expected after platelet-rich plasma injection compared with extracorporeal shockwave therapy in patients with a refractory lateral epicondylitis.