Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review.

Abstract

BACKGROUND:

Chronic lateral epicondylar tendinopathy is frequent in athletes, and platelet-rich plasma (PRP) is being used increasingly in its treatment.

OBJECTIVE:

To systematically review the literature on the efficacy of PRP injections for chronic lateral epicondylar tendinopathy.

METHODS:

The databases of PubMed, EMBASE, CINAHL, Medline OvidSP, Scopus, Google Scholar, Web of Science and Cochrane Library were searched in October 2013. Inclusion criteria were a clinical diagnosis of chronic lateral epicondylar tendinopathy, a randomised controlled trial, an intervention with a PRP injection and the outcome measures described in terms of pain and/or function. One author screened the search results and two authors independently assessed the study quality using the Physiotherapy Evidence Database (PEDro) score. A study was considered to be of high quality if its PEDro score was ≥6. A best evidence synthesis was used to identify the level of evidence.

RESULTS:

6 studies were included, of which four were considered to be of high quality. Three high-quality studies (75%) and two low-quality studies showed no significant benefit at the final follow-up measurement or predefined primary outcome score when compared with a control group. One high-quality study (25%) showed a beneficial effect of a PRP injection when compared with a corticosteroid injection (corticosteroid injections are harmful in tendinopathy). Based on the best evidence synthesis, there is strong evidence that PRP injections are not efficacious in chronic lateral epicondylar tendinopathy.

CONCLUSIONS:

There is strong evidence that PRP injections are not efficacious in the management of chronic lateral elbow tendinopathy.

• Authors: Robert-Jan de Vos, Johann Windt, Adam Weir
• Journal: British journal of sports medicine (Br J Sports Med) Vol. 48 Issue 12 Pg. 952-6 (Jun 2014) ISSN: 1473-0480 [Electronic] England
• PMID: 24563387 (Publication Type: Journal Article, Review, Systematic Review)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Topics

• Chronic Disease
• Evidence-Based Medicine
• Humans
• Injections
• Platelet-Rich Plasma
• Tennis Elbow (therapy)
• Treatment Outcome