Platelet-Rich Plasma Versus Corticosteroids in the Management of Chronic Tendinopathies: A Randomized Comparative Study Across Three Anatomical Sites

Abstract

Background:
Chronic tendinopathies such as Achilles tendinitis, lateral epicondylitis, and De Quervain’s tenosynovitis often respond poorly to conservative treatment, leading to persistent pain and impaired function. Corticosteroid injections, though commonly used, offer only transient relief with high recurrence rates. Platelet-rich plasma (PRP), an autologous biologic product rich in growth factors, is emerging as a regenerative alternative with longer-lasting benefits.

Objective:
To compare the efficacy and safety of PRP versus corticosteroid injections in patients with chronic tendinopathies, evaluating outcomes across pain intensity, functional improvement, patient satisfaction, and recurrence over six months.

Methods:
A prospective, randomized controlled study was conducted on 60 patients diagnosed with chronic tendinopathy, equally divided into PRP (n = 30) and corticosteroid (n = 30) groups. PRP was prepared using a double-spin method under sterile conditions. After baseline assessment, all participants received ultrasound-guided injections, and follow-up assessments were conducted at 1, 3, and 6 months. Outcomes included pain intensity (using a Visual Analog Scale), functional performance (condition-specific score normalized to a 0–100 scale), patient satisfaction (evaluated with a 5-point Likert scale), recurrence, and adverse events.

Results:
At six months, the PRP group showed significantly lower pain scores (VAS: 2.17 ± 1.01) compared to the corticosteroid group (3.49 ± 0.77; p < 0.001). Functional improvements were greater in the PRP group, with scores averaging 88.07 ± 9.25 versus 81.96 ± 6.01 in the corticosteroid group. Satisfaction was higher following PRP therapy, with 90% of patients rating their experience favorably, compared to 46.7% in the corticosteroid group. Although symptom recurrence was less common in the PRP group (10.0% versus 23.3%), this difference was not statistically significant. Both treatments were well tolerated with only minor, self-limiting adverse effects.

Conclusion:
PRP therapy demonstrated superior outcomes compared to corticosteroids in the management of chronic tendinopathies, including greater pain relief, enhanced functional recovery, and higher patient satisfaction, with a favorable safety profile and reduced recurrence trend. PRP should be considered a reliable and effective injectable option for long-term management of chronic tendinopathies across anatomical sites.