Joost Peerbooms

141 Summary The application of PRP for upper limb conditions has also increased. In this chapter the literature is reviewed. We came to the conclusion that the use of PRP for upper limb conditions should be studied in more detail. Chapter 5 describes a randomised clinical trial in patients with lateral epicondylitis. The trial was conducted in two teaching hospitals in the Netherlands. A total of 100 patients with chronic lateral epicondylitis were randomly assigned to a PRP-group ( n = 51) or a corticosteroid-group ( n = 49). Patients received either a corticosteroid injection or a PRP injection. The primary analysis included VAS and DASH scores. Successful treatment was defined as a reduction of at least 25% in VAS or DASH score after 1 year without reintervention. According to the VAS scores, 24 of the 49 patients (49%) in the corticosteroid-group and 37 of the 51 patients (73%) in the PRP group had a successful treatment outcome; this was a significant difference ( P < .001). A significant difference ( P = .005) was also observed between the DASH scores of the two groups, with 25 of the 49 patients (51%) in the corticosteroid-group and 37 of the 51 patients (73%) in the PRP-group displaying a successful treatment outcome. The decrease in the scores of the corticosteroid-group was greater initially but then declined, whereas the scores of the PRP group decreased more progressively. Treatment of chronic lateral epicondylitis with PRP reduces pain and significantly improves function, exceeding the effect of corticosteroid injection. When deciding to use PRP for lateral epicondylitis in the future, clinicians should take into account further follow-up from this trial and consider possible costs and harms as well as benefits. In Chapter 6 we describe the long-term effect of PRP injection after a follow-up of 2 years. The PRP-group was more often successfully treated than the corticosteroid-group ( P < .0001). Success was defined as a 25% reduction in VAS or DASH score after 2 years without reintervention. When the baseline VAS and DASH scores were compared with the scores from the 2-year follow-up, both groups significantly improved over time. However, the DASH scores of the corticosteroid-group returned to baseline levels, while those of the PRP-group significantly improved. There were no complications related to the use of PRP. The use of PRP in the treatment of patients with chronic lateral epicondylitis reduces pain and increases function significantly, exceeding the effect of corticosteroid injection even after a follow-up of 2 years. Chapter 7 describes a randomised clinical trial in patients with plantar fasciitis. A total of 115 patients with plantar fasciitis were randomised to a PRP-group ( n = 63) or a corticosteroid-group ( n = 52). The primary analysis included the FFI Pain score. Secondary outcomes were the FFI Activity, FFI Disability, AOFAS score and the WHOQOL BREF. Seventy-three % of the patients in the PRP-group and 69% of patients in the corticosteroid-group completed the study. The PRP-group showed significantly lower 9