Kwapisz Adam, Prabhakar Sharad, Compagnoni Riccardo, Sibilska Aleksandra, Randelli Pietro
Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, Lodz, Poland.
Department of Orthopedics Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Curr Rev Musculoskelet Med. 2018 Dec;11(4):598-606. doi: 10.1007/s12178-018-9520-1.
Platelet-rich plasma is used in many orthopedic pathologies such as tendinopathies and ligament injuries. The clinical results reported in the scientific literature are, however, confusing. The aim of this manuscript is to provide a narrative literature review regarding the role of PRP in the most common elbow soft tissue pathologies.
The response to PRP seems to be favorable when compared to steroid injection for pain management and for patient-reported outcomes in lateral epicondylitis. PRP injection does not seem to have the potential complications associated with a steroid injection such as skin atrophy, discoloration, and secondary tendon tears. Only a few manuscripts comparing the results of PRP treatment with either extracorporeal shockwave (ESW), dry needling, or even surgical treatments in lateral epicondylitis exist. The use of PRP in other elbow pathologies such as golfer's elbow, ulnar collateral ligament injury, and distal biceps and triceps pathology is examined in few studies, with unclear recommendations. Regarding elbow pathologies, PRP injections in tennis elbow seems to be the best-studied intervention. A major limitation in these studies is the significant heterogeneity in the methods used for preparing PRP, for example employing leukocyte-rich, leukocyte-poor preparations, PRP with or without activation, which makes the results of the studies difficult to compare. Results of this review show that more studies on larger cohorts, with comparable formulations, and with longer follow-up are required to give optimal suggestions concerning the use of PRP in elbow pathologies.
富血小板血浆被用于许多骨科疾病，如肌腱病和韧带损伤。然而，科学文献中报道的临床结果却令人困惑。本文的目的是对富血小板血浆在最常见的肘部软组织疾病中的作用进行叙述性文献综述。
与类固醇注射相比，在外侧上髁炎的疼痛管理和患者报告的结果方面，富血小板血浆的反应似乎更好。富血小板血浆注射似乎没有类固醇注射相关的潜在并发症，如皮肤萎缩、色素沉着和继发性肌腱撕裂。关于外侧上髁炎，只有少数手稿比较了富血小板血浆治疗与体外冲击波（ESW）、干针疗法甚至手术治疗的结果。在少数研究中探讨了富血小板血浆在其他肘部疾病中的应用，如高尔夫球肘、尺侧副韧带损伤以及肱二头肌和肱三头肌远端病变，建议不明确。关于肘部疾病，网球肘的富血小板血浆注射似乎是研究最多的干预措施。这些研究的一个主要局限性是制备富血小板血浆所使用的方法存在显著异质性，例如使用富含白细胞、缺乏白细胞的制剂，激活或未激活的富血小板血浆，这使得研究结果难以比较。本综述结果表明，需要更多关于更大队列、具有可比配方且随访时间更长的研究，以便就富血小板血浆在肘部疾病中的应用给出最佳建议。
