Lateral epicondylitis with tendon tear resistant to conservative treatment remains a common clinical condition with limited therapeutic options before surgery is considered.
Platelet-rich plasma (PRP) injections are used in tendinopathies because of their potential regenerative properties. More recently, platelet-rich plasma derived from bone marrow aspirate (bone marrow-derived PRP) has emerged as an alternative source of platelets and bioactive factors. However, the clinical implications of its different biological composition compared with peripheral blood-derived PRP remain poorly understood.
This monocentric randomized pilot trial aims to assess the feasibility of the intervention and to estimate the effect of bone marrow-derived PRP compared with peripheral blood-derived PRP in patients with resistant partial-thickness lateral epicondylar tendinopathy.
Participants will be randomly assigned in a 1:1 ratio to receive either bone marrow-derived PRP or peripheral blood-derived PRP injection. Clinical outcomes, pain, functional scores, imaging findings, safety, and feasibility parameters will be assessed over a 12-month follow-up period.
The study is not powered to demonstrate superiority between treatments but is intended to generate preliminary effect estimates and feasibility data for the design of a future confirmatory trial.
Inclusion Criteria:
Exclusion Criteria:
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Outcome assessors are blinded to treatment allocation. Clinical follow-up assessments are performed by an orthopedic surgeon who does not have access to the randomization sequence or treatment assignment. Ultrasound follow-up evaluations are performed by a radiologist who did not perform the intervention. Participants are instructed not to disclose their treatment allocation during follow-up visits. Any accidental unblinding will be documented.
Participants receive a platelet-rich plasma (PRP) injection prepared from bone marrow aspirate obtained from the posterior iliac crest. After processing, the PRP is injected under ultrasound guidance into the affected lateral elbow tendon.
Participants receive a platelet-rich plasma (PRP) injection prepared from peripheral venous blood. After processing, the PRP is injected under ultrasound guidance into the affected lateral elbow tendon.
Platelet Rich Plasma (PRP) in Chronic Epicondylitis
Leukocyte-Poor Platelet-Rich Plasma Reduces Pain Symptoms in the Treatment of the Lateral Epicondylitis
Evaluation of Platelet-Rich Plasma (PRP) Treatment in Tendinopathies
Identification of Responders to Platelet-Rich Plasma (PRP) Injections in Lateral Elbow Epicondylalgia
Impact of Autologous Pure Platelet-rich Plasma in the Treatment of Tendon Disease
Comparison of Platelet Rich Plasma and Alternative Therapies for the Treatment of Tennis Elbow (Lateral Epicondylitis)
Treatment of Epicondylitis by Ultrasound-guided Local Injections of PRP (Platelet Rich Plasma)
PRP Versus Saline in Lateral Epicondylitis