Gonca Sağlam, Dilek Çetinkaya Alişar

Department of Physical Medicine and Rehabilitation, Erzurum Regional Training and Research Hospital, Erzurum, Türkiye

Keywords: Lateral epicondylitis, platelet-rich plasma, ultrasound.


Objectives: This study aims to compare the effectiveness of palpation-guided and ultrasound (US)-guided platelet-rich plasma (PRP) injections in patients with chronic lateral epicondylitis (LE).

Patients and methods: Between January 2021 and August 2021, a total of 60 patients (34 males, 26 females; mean age: 40.5±10.9 years; range, 22 to 64 years) diagnosed with chronic LE were included. The patients were randomly allocated to either the palpation-guided (n=30) or the US-guided injection group (n=30) before they received PRP injection. All patients were assessed using the Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH) scale, and grip strength at baseline and at one, three, and six months after injection.

Results: Baseline sociodemographic and clinical variables were statistically similar between two groups (p>0.05). The VAS and DASH scores improved significantly after the injection at each control, as well as grip strength in both groups (p<0.001). No statistically significant difference was found between the groups regarding VAS and DASH scores, and grip strength at one, three, and six months post-injection (p>0.05). No significant complication related to the injection was observed in any of the groups.

Conclusion: This study demonstrates that both palpation-guided and US-guided PRP injection protocols can improve clinical symptoms and functional parameters of patients with chronic LE.

Citation: Sağlam G, Çetinkaya Alişar D. Ultrasound-guided versus palpation-guided platelet-rich plasma injection for the treatment of chronic lateral epicondylitis: A prospective, randomized study. Arch Rheumatol 2023;38(1):67-74.

Ethics Committee Approval

The study protocol was approved by the Erzurum Regional Training and Research Hospital Ethics Committee (date: 18.01.2021, no: 2021/02-24). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Conceived and designed the study: G.S., D.Ç.A.; Collected the data: G.S., D.Ç.A.; Data analysis and interpretation: G.S., D.Ç.A.; Prepared the manuscript and reviewed the literature: G.S.; All authors have read the manuscript and agreed to the conclusion.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This study was supported by Intraline Co. Ltd.


We thank Dr. Kaan Aliar for his expertise and assistance at the Ultrasound unit.