Case Study: Platelet Rich Plasma (PRP) for Elbow Partial Thickness Tendon tear
The patient is a thirty-something female with right upper extremity pain and numbness. Her pain started some years ago with tingling in her wrist and hand. She has pain in her wrist and elbow and has had some therapy and a splint.
Ongoing therapy has alleviated some of her symptoms, but with further examination a partial-thickness tear in her tendon at her elbow was discovered originating from lateral epicondylitis (tennis elbow). The patient underwent a Platelet Rich Plasma (PRP) injection. Following, the treatment protocol she hardly has any discomfort in her elbow and has excellent strength and extension in her wrist.
What is Platelet Rich Plasma Therapy?
Platelets are small biological packages that normally circulate in the blood. They contain blood clotting factors as well as many growth factors. The growth factors promote healing by encouraging the growth of new blood vessels to help heal tendons, ligaments, and cartilage. This healing ability can be harnessed by drawing a small amount of your blood, placing it in a centrifuge to concentrate the platelets, and re-injecting the concentrated platelet-rich plasma (PRP) where your body needs help healing muscles, joints, or tendons. Because joint linings, tendons and ligaments receive very limited blood supply on thier own, injecting them platelet-rich plasma can encourage the growth of new blood vessels and be of great benefit.
Why use PRP?
The body’s ability to repair and replace damaged cartilage, tendon, or other specialized tissue in adults is limited. Injured joints or tendons can be a source of chronic pain and can limit activities. PRP therapy can harness the body’s own healing ability to allow more complete healing than other alternatives. Furthermore, PRP is a natural treatment that uses nothing more than your body’s own blood.
Initial Sonographic Analysis 07/07/2015:
A. Subcutaneous tissue
B. Partial thickness tear. Common extensor tendon tear of the elbow. End result of chronic tennis elbow (Lateral epicondylitis)
C. Radius
Initial Comprehensive Consultation – Patient’s Perceived Elbow Function with the Comprehensive Outcomes Management Technology (COMT) Questionnaire
At CROM, we track not only the remodeling and regenerative area of the injury, but also, the patient’s perspective of their functional gains. We believe that tissue healing should correlate with recovery of activities. The following is the patient’s initial functional questionnaire results. She indicated that her elbow injury is not allowing her to sleep comfortably and her elbow pain is impacting her ability to work full-time.
PRP Procedure 07/22/2015:
A. Needle for PRP – Injection at the common extensor tendon tear
B. Tendon
C. Radius
Post-op Images and Results
The healing of the tendon is seen in the next ultrasound. From a functional level, using the self-report patient elbow questionnaire, she has improved significantly. Almost three months post-PRP and following the upper extremity PRP protocol, the image indicates the tear has healed and patient has regained her strength and has removed her elbow discomfort and pain.
Sonographic Analysis 9/30/2015
A. Subcutaneous tissue
B. Common Extensor Tendon
C. Radius
Patient’s Perceived Elbow Function
Following the upper extremity protocol for PRP procedures, the patient’s self-report function in her elbow has increased from 58% to 75%. She is now able to sleep comfortably and her elbow function is high. Her self-reported functional gains, match the ultrasound results, of a healed tear.
