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Platelet Rich Plasma Augmentation to Surgical Treatment of Lateral Epicondylitis: Technique and Early Results
Christopher S Frey, MD1, Kalpit N Shah, MD2 and Jeffrey Yao, MD1, (1)Stanford University, Redwood City, CA, (2)Brown University, Providence, RI

HYPOTHESIS
We tested the hypothesize that lateral epicondylitis surgery augmented with PRP may have improved short term clinical outcomes compared to surgery without augmentation.

METHODS
A retrospective chart review of patients who underwent operative management of lateral epicondylitis with Stanford Health Care was performed. Utilizing the STARR database, patients were included if they underwent surgery with the senior author, Dr. Yao, and had a baseline QuickDASH score. Exclusion criteria included age younger than 18, percutaneous tenotomy or other surgeries with the same CPT code, and concomitant or perioperative surgery other than soft tissue release. All operations were performed by the senior author with the same technique except for PRP augmentation. If PRP was to be used intraoperatively, venous blood was drawn before tourniquet inflation. This was performed by a PM&R co-surgeon. The PRP is then used to soak 2-0 Vicryl which is then used for tendon repair. It is next injected into the repair site after closure. Patients then underwent the same, routine, postoperative care routine. QuickDASH surveys were administered preoperatively, 1 week, 6 weeks, and 3 months postoperatively. A multivariate regression and ANOVA test were used to analyze results.

RESULTS
Of the 28 patients who met criteria, 5 (18%) received PRP augmentation. Increasing age and not having diabetes was significantly associated with a greater decrease in QuickDASH scores (p<0.01). Patients across both groups had significant increase in QuickDASH scores at 6 weeks (p<0.01) and a decrease by 3 months (p<0.001). There was no significant difference between PRP-augmented and non-PRP-augmented groups. There were no complications.

Conclusion
There was no significant difference in postoperative QuickDASH scores between augmented and non-augmented lateral epicondyle debridement. Patients across both groups had significant increase in QuickDASH scores at 6 weeks and a decrease by 3 months to below baseline. Older and non-diabetic patients experienced greated improvement in QuickDASH scores.


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