Comparison of ultrasound-guided dry needling and platelet-rich plasma injection in the management of refractory lateral epicondyle tendinopathy

Background: This prospective randomized study aimed to compare the clinical effectiveness of ultrasound-guided dry needling and platelet-rich plasma injections in patients with refractory lateral epicondyle tendinopathy. Methods: Fifty patients (25 in each group) diagnosed with refractory lateral epicondyle tendinopathy were randomized to receive either ultrasound-guided dry needling or platelet-rich plasma injection. Patients were evaluated before treatment and at 1, 3, and 6 months after the intervention using the visual analog scale, the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, the Patient-Rated Tennis Elbow Evaluation, and grip strength measurements. All procedures were performed under continuous ultrasound guidance. Results: Both groups showed significant improvements in pain, function, and grip strength over time. There were no significant differences in grip strength between the groups at any time point. However, patients treated with platelet-rich plasma showed superior outcomes in pain and functional scores, particularly at the 6-month follow-up. No complications were observed in any of the patients. Conclusions: Both ultrasound-guided dry needling and platelet-rich plasma injections are effective options for refractory lateral epicondyle tendinopathy. Platelet-rich plasma may offer greater clinical benefit, particularly in pain reduction and functional improvement. Further research with larger cohorts is required to establish optimal treatment protocols. Level of evidence: I.