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

Introduction: Elbow lateral epicondylitis is a common problem that usually resolves with conservative treatment modalities such as local infiltration with steroids, ultrasonic therapy, manipulation, and finally operative procedures are tried. An alternative to surgical intervention is sought for when the conservative measures fail. Purpose: The hypothesis of this study is to establish the role of local autologous plasma injection to bring along biological cure in these cases. Materials and Methods: A total of 40 patients (40 elbows) with persisting pain for approximately 6 months, despite another 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 an active range of exercises was followed in every patient. The outcome was rated by post procedure visual analog pain scores (VAS) and Mayo elbow performance scores (MEPSs). Informed consent had been obtained from the subjects, and the study protocol was approved by the institutional ethics committee. Results: All patients in this study noted improvement in their VAS and MEPS. Minimal complication occurred in some 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: The treatment of patients with refractory lateral epicondylitis with local autologous plasma reduced pain significantly. Hence, local autologous plasma injection is a viable option to be considered before contemplating surgical intervention in refractory lateral epicondylitis of humerus.