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Patient's Own Blood Cells Treat Tennis Elbow

Researchers harness the power of platelets to heal torn tendons

TUESDAY, Oct. 24, 2006 (HealthDay News) -- Using patients' own platelets, doctors report they were able to successfully treat tennis elbow.

This procedure involves taking a patient's platelets and injecting them directly into the damaged tendon. Once in the tendon, the natural healing power of the platelets takes over and begins to repair the torn and frayed areas of the tendon.

The use of platelet-rich plasma was pioneered in dentistry to help grow bone and gum for dental implants. Now, the technique is being used to repair tendons and ligaments in various parts of the body and to help heal wounds and grow bone. Platelet-rich plasma contains powerful growth factors that start healing in the tendon and may attract other body cells to help in repair.

In the new study, Dr. Allan Mishra and Terri Pavelko, of the Menlo Medical Clinic at Stanford University Medical Center, reported the first results of using the technique to treat severe tennis elbow in the November issue of the American Journal of Sports Medicine.

"This is the first use of your own growth factors for the treatment of chronic tendonitis," Mishra said. "Platelets are components of the blood that help form clots, but they also have powerful growth factors that help initiate healing."

The hope is that this technique will help patients with severe chronic tendonitis avoid surgery, Mishra said.

In the study, Mishra and Pavelko treated 20 patients who had severe tennis elbow that had not improved with time or physical therapy. Fifteen patients were given an injection of platelet-rich plasma into the affected elbow. The other five patients were not treated.

A day after the procedure, the patients started a two-week stretching program and, after a month, they were allowed to return to normal sporting and recreational activities.

Mishra and Pavelko found that, after six months, the patients treated with platelet-rich plasma had an 81 percent improvement in pain scores. After two years, 93 percent of these patients said they were completely satisfied with the treatment, and 7 percent were partially satisfied. Among the patients who received platelet-rich plasma, most had returned to the normal activities of daily living, and more than 90 percent had returned to work or sporting activities.

"Your body has a tremendous ability to heal itself," Mishra said. Based on these results, Mishra is conducting a larger trial involving 240 patients.

"We have a long way to go," he said. "But this has the potential to be a safe and effective way to treat chronic and severe tendonitis."

One expert thinks this treatment will become the standard way of treating severe tendonitis.

"I think it works," said Dr. Michael A. Scarpone, medical director of Riverside Sports Fitness and Rehabilitation Center in Ohio and a team physician for the Pittsburgh Pirates. "It's probably the way we are going to treat people in the future."

Scarpone said one of the advantages of the technique is that it is safe and minimally invasive. In fact, he is using it to treat torn rotator cuffs and has used it on well over 100 patients.

For most people, this method will probably be used when other treatments fail, Scarpone noted. "But in the sports world, it is being used in the acute phase," he said. In addition, the technique has also been used in combination with other therapies such as surgery, he noted.

"There are answers now, especially for tendon and ligament problems," Scarpone said. "You will see it used more for tendons and ligaments that won't heal."

More information

The U.S. National Library of Medicine can tell you more about tennis elbow.

SOURCES: Allan Mishra, M.D., Menlo Medical Clinic, Stanford University Medical Center, Menlo Park, Calif.; Michael A. Scarpone, D.O., medical director, Riverside Sports Fitness and Rehabilitation Center, Steubenville, Ohio, and team physician, Pittsburgh Pirates; November 2006, American Journal of Sports Medicine
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