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Elbow disorders
such as lateral epicondylitis (tennis elbow), medial epicondylitis (golfer’s elbow), and ulnar collateral ligament (UCL) injuries are common conditions, especially in athletes. While traditional treatments like rest, physical therapy, bracing, and surgery are often used, there is growing interest in orthobiologics as less invasive options. This review will discuss the current evidence for platelet-rich plasma (PRP) and stem cell therapies in managing elbow pathology.
Platelet-Rich Plasma (PRP)
PRP is an autologous blood product that contains high concentrations of growth factors which may enhance tissue healing. Several small studies have evaluated PRP injections for lateral epicondylitis. A 2014 systematic review found PRP may provide short-term benefits in pain and function compared to placebo, but the evidence was limited by low quality studies. For medial epicondylitis, a small 2013 study showed PRP and autologous blood injections provided similar improvements in pain and disability. In UCL injuries, evidence for PRP is limited to small case series suggesting potential benefit, but controlled trials are lacking.
Stem Cell Therapy
Mesenchymal stem cells (MSCs) derived from bone marrow or adipose tissue have the capacity to differentiate into various cell types involved in tissue repair. However, the use of stem cells for elbow disorders is still in early stages. A 2016 case report described good outcomes with bone marrow-derived MSCs for a partial UCL tear in a professional baseball pitcher. Another small 2017 case series reported improvements in pain and MRI appearance after ultrasound-guided injection of bone marrow aspirate concentrate for lateral epicondylitis. Large controlled studies are needed though to establish the efficacy and safety of stem cell therapies.
Limitations and Future Directions
Current evidence for orthobiologics in elbow disorders is limited by small sample sizes, lack of control groups, and short-term follow-up. Optimal preparation methods, composition, and dosing still need to be determined. Long-term safety, especially of stem cell therapies, remains unknown. Standardized outcome measures are also needed to allow comparison across studies. Ultimately, randomized controlled trials with larger sample sizes and longer follow-up are required to guide treatment decisions.
©2025 Dr Frank McCormick All Rights Reserved.
©2025 Dr Frank McCormick All Rights Reserved.