Platelet Rich Plasma versus Corticosteroid Injection for Chronic Lateral Epicondylitis: Clinical Outcomes in a Prospective Randomized Comparative Study

ABSTRACT Background: Lateral epicondylitis (tennis elbow) is a degenerative tendinopathy of the common extensor origin. Corticosteroid injection gives quick pain relief but its benefit often fades, whereas autologous platelet-rich plasma (PRP) aims to promote tendon repair. Evidence from Indian centres remains limited. We compared PRP and corticosteroid injections for pain and function over 12 weeks. Methods: In this prospective randomized comparative study conducted from June 2024 to June 2026, 80 adults with chronic (more than 3 months) lateral epicondylitis were randomly allocated 1:1 to a single injection of autologous PRP (3–4 ml; n = 40) or triamcinolone acetonide 40 mg with 2 ml of 1% lignocaine (n = 40). Pain (Visual Analogue Scale, VAS, 0–100 mm) and function (Disabilities of the Arm, Shoulder and Hand, DASH, 0–100) were recorded at baseline and at 4, 8 and 12 weeks. Groups were compared with the independent t-test, and within-group change with the paired t-test. Results: All 80 patients completed follow-up (mean age 44.8 ± 8.6 years; 65% women; 88.75% right-sided). Baseline VAS (68.4 ± 7.3 vs 67.2 ± 6.8) and DASH (58.6 ± 8.1 vs 57.2 ± 7.6) were comparable. At 4 weeks the steroid group had lower VAS (47.6 ± 7.0 vs 54.5 ± 7.4; p < 0.001); DASH did not differ (p = 0.43). At 8 weeks neither score differed. At 12 weeks VAS was similar (36.5 ± 6.5 vs 37.8 ± 6.7; p = 0.37), but DASH was lower with PRP (29.1 ± 6.8 vs 34.0 ± 7.0; p = 0.002). Both groups improved significantly from baseline (p < 0.001). The DASH reduction from baseline was greater with PRP (29.5 vs 23.2 points; p = 0.007). No major complications occurred. Conclusion: Corticosteroid injection gave faster early pain relief, while PRP produced continued improvement and better function at 12 weeks with equivalent pain relief. The between-group DASH difference was modest and below the published minimal clinically important difference, so longer, blinded, multicentre trials are needed. Keywords: lateral epicondylitis; tennis elbow; platelet-rich plasma; corticosteroid; triamcinolone; DASH; visual analogue scale; India