Arthroscopic Debridement Versus Platelet-Rich Plasma Injection: A Prospective, Randomized, Comparative Study of Chronic Lateral Epicondylitis With a Nearly 2-Year Follow-Up

Arthroscopy. 2017 Jul;33(7):1320-1329. doi: 10.1016/j.arthro.2017.02.009. Epub 2017 Apr 19.


Purpose: The purpose of this prospective, randomized study was to compare the efficacy of autologous platelet-rich plasma (PRP) injections and arthroscopic lateral release in treating chronic lateral epicondylitis (LE).

Methods: Patients who had a clinical diagnosis of LE confirmed by ultrasound (US) were included in this study. A total of 101 patients received arthroscopic release (n = 50) or US-guided PRP injections (n = 51). Outcomes were assessed using a visual analog scale for pain, the Patient-Rated Tennis Elbow Evaluation (PRTEE), and a calibrated hand dynamometer for grip strength.

Results: Both patient groups experienced significant improvement in all measures. Between-group comparisons showed a significantly higher value in the PRP group only for grip strength at week 8 (P = .0073); all other significant differences were in favor of arthroscopy: overall pain (P = .0021), night pain (P = .0013), and PRTEE score (P = .0013) at week 104 and grip strength at weeks 24, 52, and 104 (all P < .0001). Consumption of rescue pain medication was not significantly different between the groups.

Conclusions: The present findings suggest that (1) PRP injections and arthroscopic extensor carpi radialis brevis release are both effective in the short and medium term; (2) PRP patients experienced a significant worsening of pain at 2 years; (3) arthroscopic release ensured better long-term outcomes in terms of pain relief and grip strength recovery; and (4) both procedures were safe and well accepted by patients. LEVEL OF EVIDENCE: Level II, prospective comparative study.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arthroscopy*
  • Debridement*
  • Female
  • Follow-Up Studies
  • Hand Strength
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Tennis Elbow / diagnostic imaging
  • Tennis Elbow / therapy*
  • Ultrasonography, Interventional
  • Visual Analog Scale