Peerbooms PRP vs steroid

Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up.

Peerbooms JC, Sluimer J, Bruijn DJ, et al. The American journal of sports medicine 2010 · PMID 20448192 · doi:10.1177/0363546509355445

Question

Is platelet-rich plasma (PRP) injection more effective than corticosteroid injection for chronic lateral epicondylitis?

Design

Double-blind RCT in two teaching hospitals in the Netherlands.

Patients

Adults with chronic lateral epicondylitis.

Intervention

Autologous platelet concentrate (PRP) injection

Comparison

Corticosteroid injection

Primary outcome

Treatment success (more than 25% reduction in VAS pain or DASH without reintervention) at 1 year

Key result

The PRP group had significantly more patients with successful pain and function outcomes at 1 year; the steroid group improved early and then declined.

Limitations

No placebo arm, so the comparison may reflect harm from steroid rather than benefit from PRP; modest sample.

Impact on practice

Frequently quoted in support of PRP, but should be read alongside placebo-controlled trials such as Krogh (2013), which did not show PRP beating saline.