There is a recently published level 2 article comparing PRP injection to dry needling for tennis elbow. Allan Mishra published the benchmark article on this topic back in 2013 in AJSM. This recent article concludes that PRP is better than dry needling at the 6 month mark and beyond. But to really understand what their PRP procedure was....we don't have enough information.
The authors drew 25.5 cc of blood.
But we don't know the patients' starting platelet count.
The authors report that they used a double spin system and the final platelet concentration was 3-4x over baseline.
But we don't know the final platelet count in PRP
We don't know the PRP volume injected.
The authors must have had this info but didn't publish it.
The result? We don't know the platelet dose used!
We know the authors did 2 injections separated by one month. We know that their PRP treatment was better than their dry needling treatment.
They describe their needling treatment as 15-20 repeated fenestrations with a needle.
BUT we don't know the gauge of the needle....was it an acupuncture needle or an 18g needle?
I would submit that there is a potential clinical difference based on the dry needling size and number of fenestrations of the tendon in a small area.
Any thoughts? I think that a single higher dose PRP injection eliminates the need for a second injection for tennis elbow most of the time. High dose would mean a 60cc blood draw and getting the platelet dose definitely above 3.5 billion and more likely up around the 5 billion range in a 3cc-4cc PRP injection. Platelet count in the PRP would be a 1200-1500 depending on the patient's starting platelet count.
Post a comment
Your email address will not be published. Fields marked (*) are mandatory.