Morphological changes in tennis elbow after PRP injection: a novel MRI-based assessment in a randomized controlled study.
Joanna Walecka, Marcin Dzianach, Izabela Rachwal-Czyzewicz et al.
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In 30 seconds
This double-blind, randomized, placebo-controlled trial assessed MRI changes after leukocyte-rich PRP, leukocyte-poor PRP, or saline injections in 71 patients with chronic lateral tendinopathy. MRI was performed before treatment and at six months, with partial tendon tear size as the primary outcome. The imaging assessment had excellent interobserver reliability (intraclass correlation coefficient >0.90). Tendon structure and muscle edema improved across all groups; LR-PRP showed an advantage for reducing tear size and soft tissue edema, but PRP was not significantly superior to saline for tendinosis resolution or muscle edema reduction.
Key findings
- The MRI assessment showed excellent interobserver reliability, with an intraclass correlation coefficient >0.90.
- Tendon structure and muscle edema improved in all groups, including the saline control.
- LR-PRP showed an advantage in reducing partial tendon tear size and soft tissue edema.
- At six months, PRP was not significantly superior to saline for tendinosis resolution or muscle edema reduction.
Why it matters
The findings illustrate that structural MRI changes after injection may occur in both PRP and saline groups, so imaging improvement alone does not establish a PRP-specific benefit. The study also describes a reproducible MRI assessment that captures tendon tears and other soft-tissue abnormalities, potentially supporting more objective evaluation of structural change in chronic lateral tendinopathy.
What to keep in mind
Follow-up MRI was limited to six months, and the reported structural improvements in several measures also occurred in the saline group.