Background: Whether the use of platelet-rich plasma (PRP) as an adjuvant to extensor carpi radialis brevis (ECRB) repair in recalcitrant lateral epicondylitis (RLE) promotes tendon healing and improves clinical outcomes remains unclear. Purpose: To evaluate the tendon healing and clinical outcomes of arthroscopic ECRB repair combined with PRP injection and compared with arthroscopic ECRB repair alone at early-term follow-up in patients with RLE. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A consecutive series of 80 patients with RLE were enrolled and randomized to the PRP group (arthroscopic ECRB repair followed by 1 PRP injection; n = 40) and the control group (arthroscopic ECRB repair alone; n = 40). Magnetic resonance imaging was performed to assess tendon healing at 3, 6, and 12 months. The visual analog scale (VAS) for pain, the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, range of motion, and muscle strength were evaluated at preoperative and follow-up points. The time to return to work was also compared between the 2 groups. Patients and assessors were blinded to the intervention. Results: A total of 80 patients who met the inclusion criteria were enrolled between July 2020 and July 2023, and 73 patients completed follow-up. The PRP group contained 35 patients, 11 men and 24 women, with a mean age of 47.8 ± 8.8 years. The control group contained 38 patients, 13 men and 25 women, with a mean age of 44.5 ± 5.8 years. No significant differences were found in magnetic resonance imaging classification and functional scores between groups at preoperative and follow-up periods. VAS, MEPS, DASH, and PRTEE scores and muscle strength showed significant improvement at 12 months in both groups ( P < .001). However, the PRP group showed a significant improvement in grip and wrist extension muscle strength at 6 weeks postoperatively ( P = .008 and P < .001, respectively), whereas the control group did not ( P = .583 and .056). No complications were associated with PRP injection. Conclusion: PRP used as an adjuvant to ECRB repair did not show a difference in tendon healing and functional outcomes compared with ECRB repair alone for RLE at 12-month follow-up. However, PRP treatment showed a difference in muscle strength at 6-week follow-up compared with ECRB repair alone. Registration: NCT04556825 (ClinicalTrials.gov).

中文翻译：

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在关节镜下释放和修复顽固性外上髁炎期间使用辅助富血小板血浆进行愈合：一项前瞻性、双盲、随机对照试验

背景：在顽固性外上髁炎 （RLE） 中使用富血小板血浆 （PRP） 作为桡侧腕短伸肌 （ECRB） 修复的辅助治疗是否促进肌腱愈合并改善临床结局仍不清楚。目的： 评价关节镜下 ECRB 修复联合 PRP 注射的肌腱愈合和临床结局，并与 RLE 患者早期随访中单独关节镜下 ECRB 修复进行比较。研究设计：随机对照试验;证据级别，1.方法： 连续系列 80 例 RLE 患者入组并随机分配到 PRP 组 （关节镜下 ECRB 修复后 1 次 PRP 注射;n = 40） 和对照组 （单独关节镜下 ECRB 修复;n = 40）。进行磁共振成像以评估 3 、 6 和 12 个月时的肌腱愈合情况。在术前和随访点评估疼痛视觉模拟量表 （VAS）、梅奥肘部表现评分 （MEPS）、手臂、肩部和手部残疾 （DASH） 问卷、患者评价的网球肘评估 （PRTEE） 量表、运动范围和肌肉力量。还比较了两组之间的重返工作岗位的时间。患者和评估者对干预不知情。结果： 2020 年 7 月至 2023 年 7 月期间共纳入 80 例符合纳入标准的患者，其中 73 例患者完成随访。PRP 组包括 35 例患者，男性 11 例，女性 24 例，平均年龄 47.8 ± 8.8 岁。对照组包括 38 例患者，男性 13 例，女性 25 例，平均年龄 44.5 ± 5.8 岁。术前和随访期间，各组磁共振成像分类和功能评分差异无统计学意义。 两组在 VAS 、 MEPS 、 DASH 和 PRTEE 评分以及肌肉力量在 12 个月时均显示显着改善 （ P < .001）。然而，PRP 组在术后 6 周时握力和腕部伸展肌力显着改善 （分别为 P = .008 和 P < .001），而对照组则没有 （P = .583 和 .056）。PRP 注射无并发症。结论： 在 12 个月的随访中，与单独 ECRB 修复相比，用作 ECRB 修复的 PRP 在肌腱愈合和功能结局方面没有差异。然而，与单独使用 ECRB 修复相比，PRP 治疗在 6 周随访时显示肌肉力量存在差异。注册：NCT04556825 （ClinicalTrials.gov）。