Molecular background behind lateral elbow pain reduction with Leukocyte-Rich and Leukocyte-Poor Platelet-Rich Plasma-randomized control trial and single-cell platelet analysis.

PURPOSE: Degeneration at the common extensor origin leads to lateral elbow pain and reduced quality of life. We conducted a double-blind, randomized, placebo-controlled trial involving 71 patients treated with leukocyte-poor PRP (LP-PRP), leukocyte-rich PRP (LR-PRP), or saline.

METHODS

PRP content was analyzed using flow cytometry, confocal microscopy, and holotomography. Clinical outcomes (Visual Analogue Scale, Oxford Elbow Score) were assessed at baseline and at three, six, 12, 24, and 55 weeks.

RESULTS

LR-PRP contained 3.8 × more leukocytes and 2.7 × fewer platelets than LP-PRP. Imaging revealed distinct platelet morphology and activation patterns between PRP types. The LP-PRP group showed significantly greater pain reduction at six weeks and improved elbow function from three to six weeks onward.

CONCLUSION

LP-PRP produced superior and longer-lasting clinical outcomes compared to LR-PRP and saline.

CLINICALTRIALS: GOV: NCT06854666 (retrospectively registered on 2025-01-13).