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\nPlatelet-Rich Plasma Injections are Associated with Higher Resource Utilization and Surgical Escalation Compared with Corticosteroids in  \nLateral Elbow Tendinopathy  \nAamir Shahzad1, Haji Bahar Ali2, Zim Warda Hassan3, Syed Amir Ali Shah4, Abeeha Oz,  \nWiqqas Jamil1  \nLearning Point of the Article:  \nIn real-world practice, PRP for epicondylitis was associated with greater short-term treatment failure and healthcare utilization than CSI, highlighting an efficacy–effectiveness gap and the need for standardized protocols and patient counseling.  \nAbstract  \nIntroduction: Epicondylitis (lateral and medial) is a common tendinopathy that impairs function and quality of life. Corticosteroid injections (CSI) provide rapid but oěen short-lived symptom relief, while platelet-rich plasma (PRP) is used as a biologic alternative aimed at tendon regeneration. Comparative effectiveness between PRP and CSI remains uncertain in real-world seĨings.  \nMaterials and Methods: We conducted a retrospective cohort study using de-identiėed electronic health records from the TriNetX Network (2010–2025). Adults ≥18 years with coded epicondylitis and subsequent PRP or CSI were included. Cohorts were 1:1 propensity-score matched on demographics and comorbidities (age, sex, race, type 2 diabetes, obesity, hypothyroidism, nicotine dependence). Outcomes were assessed over a period of 1 year aěer the index event and included repeat or new medication, opioid exposure, long-term opioid initiation, visits to the emergency department (ED), functional diagnoses (stiffness, weakness, mobility), physical therapy (PT) utilization, and surgical escalation. Hazard ratios (HRs) and risk ratios were estimated.  \nResults: Aěer matching, 1,064 PRP patients were compared with 1,064 CSI patients. PRP was associated with higher hazards of repeat or new medication (HR 1.33; 95% CI 1.18–1.50; RR 1.21), opioid exposure (HR 1.48; 95% CI 1.20–1.83; RR 1.43), PT utilization (HR 1.52; 95% CI 1.27–1.81; RR 1.41), joint stiffness (HR 1.64; 95% CI 1.04–2.59; RR 1.63), dependence on mobility aids (HR 3.63; 95% CI 1.80–7.31; RR 3.60), and surgical escalation (HR 2.57; 95% CI 1.19–5.56; RR 2.30). No signiėcant differences were observed for ED visits, long-term opioid initiation, abnormal gait, muscle weakness, or contracture.  \nConclusion: In this large, multi-institutional real-world cohort, PRP was associated with higher short-term utilization and treatment failure risks compared with CSI. While randomized trials suggest mid-term beneėts ofPRP, our ėndings highlight an efficacy–effectiveness gap, likely reĚecting heterogeneity in PRP protocols and patient selection. Clinicians should counsel patients about the potential for early symptom Ěare and higher downstream resource use when considering PRP.  \nKeywords: Epicondylitis, tennis elbow, platelet-rich plasma, corticosteroid injection, real-world evidence.  \nIntroduction elbow”) and less oěen medial, affects working-age adults  \nEpicondylitis, most commonly lateral epicondylitis (“tennis disproportionately and imposes a meaningful clinical and  \n\n|  | Author’s Photo Gallery |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| \u003Cbr>Access this article online | | | | | | |\n| \u003Cbr>Website: [www.jocr.co.in](www.jocr.co.in)\u003Cbr>\u003Cbr>DOI:\u003Cbr>hĨ[ps://doi.org/10.13107/jocr.2025.v15.i12.6534](ps://doi.org/10.13107/jocr.2025.v15.i12.6534) |  Dr. Haji BaharAli Dr. Zim Warda Hassan Dr. Syed Amir Ali Shah  Mr. Wiqqas Jamil\u003Cbr>\u003Cbr>1Department of Trauma and Orthopedic Surgery, Tameside and Glossop Integrated Care NHS Trust, Greater Manchester OL6 9RW, United Kingdom,\u003Cbr>2ĉird Year MBBS Student, Punjab Medical College, Faisalabad Medical University, Faisalabad 38000, Pakistan, 3Research Fellow, Clinical and Translational Science, School of Medicine, West Virginia University, USA, 4Department of Trauma and Orthopeadics Surgey, Alama General Hospital, Kingdom of Saudi","cbCailVIMvvvq9BK","https://ap.wps.com/l/cbCailVIMvvvq9BK","pdf",10325847,"English","# Introduction\n## Materials and Methods\n## Results\n## Conclusion\n# Keywords","[{\"question\":\"How was PRP compared with corticosteroid injections in the study?\",\"answer\":\"The study used a retrospective cohort from de-identified TriNetX electronic health records (2010–2025) and performed 1:1 propensity-score matching on demographics and comorbidities.\"},{\"question\":\"What outcomes showed higher utilization or failure with PRP versus CSI?\",\"answer\":\"PRP was associated with higher hazards of repeat or new medication, opioid exposure, PT utilization, joint stiffness, dependence on mobility aids, and surgical escalation.\"},{\"question\":\"Were there any outcomes that did not differ significantly between PRP and CSI?\",\"answer\":\"No significant differences were observed for ED visits, long-term opioid initiation, abnormal gait, muscle weakness, or contracture.\"}]","Platelet-Rich Plasma Injections are Associated with Higher Resource Utilization and Surgical Escalation Compared with Corticosteroids in Lateral Elbow Tendinopathy - Real-world Study | PDF",1790721215,23]