Treatment of Refractory Lateral Epicondylitis of Humerus with Local Autologous Plasma Injection

Background: Elbow lateral epicondylitis is a common problem that usually resolves with conservative treatment modalities like local infiltration with steroids, ultrasonic therapy, and manipulation and finally operative procedures are tried. An alternative to surgical intervention is sought for when the conservative measures failed. The hypothesis of this study is to establish the role of local autologous plasma injection to bring alone biological cure in these cases. Material and Methods: Forty patients with persisting pain for approximate six months, despite of other conservative mode of intervention were treated. The patients were injected with 2cc autologous plasma locally at the site of epicondylitis aseptically after preparation by centrifugation of 5cc blood. A post procedure physiotherapy program with active range of exercise was followed in every patient. Outcome was rated by post procedure visual analog pain scores (VAS) and Mayo elbow performance scores (MEPS). Informed consent had been obtained from the subjects. Result: All patient in this study noted improvement in their VAS and MEPS. Minimal complication occurred in same patients. Mean VAS improved from 74.9 to start with to 41.5 at 4 weeks,29.8 at 8 and 18.5 at 6 months follow up. Mean MEPS improved from 50.3 to start with to 71.8 at 4 weeks,79.7 at 8 weeks and 84 at 6 months follow up. Conclusion: Treatment of patient with refractory lateral epicondylitis with local autologus plasma reduced pain significantly. Hence, local autologus plasma injection is a viable option to be considered before contemplating surgical intervention in refractory lateral epicondylitis of humerus. Keyword: Refractory lateral epicondylitis, tennis elbow, tendinitis, tendinosis. Study: Cohort study, level of Evidence 1.