Use of Adjunctive Platelet-Rich Plasma for Healing During Arthroscopic Release and Repair for Recalcitrant Lateral Epicondylitis: A Prospective, Double-Blind, Randomized Controlled Trial

BACKGROUND: Whether the use of platelet-rich plasma (PRP) as an adjuvant to extensor carpi radialis brevis (ECRB) repair in recalcitrant lateral epicondylitis (RLE) promotes tendon healing and improves clinical outcomes remains unclear. PURPOSE: To evaluate the tendon healing and clinical outcomes of arthroscopic ECRB repair combined with PRP injection and compared with arthroscopic ECRB repair alone at early-term follow-up in patients with RLE. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A consecutive series of 80 patients with RLE were enrolled and randomized to the PRP group (arthroscopic ECRB repair followed by 1 PRP injection; n = 40) and the control group (arthroscopic ECRB repair alone; n = 40). Magnetic resonance imaging was performed to assess tendon healing at 3, 6, and 12 months. The visual analog scale (VAS) for pain, the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, range of motion, and muscle strength were evaluated at preoperative and follow-up points. The time to return to work was also compared between the 2 groups. Patients and assessors were blinded to the intervention. RESULTS: = .583 and .056). No complications were associated with PRP injection. CONCLUSION: PRP used as an adjuvant to ECRB repair did not show a difference in tendon healing and functional outcomes compared with ECRB repair alone for RLE at 12-month follow-up. However, PRP treatment showed a difference in muscle strength at 6-week follow-up compared with ECRB repair alone. REGISTRATION: NCT04556825 (ClinicalTrials.gov).