"We know that in the natural history of lateral epicondylitis 80% of patients are healed in one year, but all patients had complaints for at least six months," Gosens and colleagues report. "In our [study], significant results were achieved only after 26 weeks [with PRP]."
Kenneth Mautner, MD, of Emory University's sports medicine center says he gets even better results than the Dutch researchers reported. He was not involved in the Gosens study.
"Their results would have been better if they had consistently used ultrasound before treatment to show whether there really was damage to the tendon," Mautner tells WebMD. "And they did not do PRP injections with ultrasound guidance, which I always do. If they did, they could have been in the 90% success range reported in a previous study."
A downside to PRP is that it isn't cheap. Not all insurance plans cover the treatment, which costs from $750 to $1,500. So when might the less-expensive corticosteroid shot be a better option?
"I use steroids for tennis elbow if someone has had two weeks of pain and it is just killing them," Mautner says. "But if it’s been several months of pain and the ultrasound or MRI shows degeneration in the tendon and no swelling around it, I won’t advise it."
Is the elbow the only tendon amenable to PRP? A recent study suggested that the treatment does not work for Achilles tendon injuries. But Mautner says his experience is different.
"PRP success is most predictable with elbows, but I have had amazing success with using it to treat Achilles tendon injuries. We have to do more research on this," he says.
Gosens presented the study findings in a report to the annual meeting of the American Academy of Orthopaedic Surgeons.