Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review
One article on PainSci cites de Vos 2014: Does Platelet-Rich Plasma Injection Work?
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
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.
- “Impact of autologous blood injections in treatment of mid-portion Achilles tendinopathy: double blind randomised controlled trial,” Bell et al, British Medical Journal, 2013.
- “Platelet-rich therapies for musculoskeletal soft tissue injuries,” Moraes et al, Cochrane Database of Systematic Reviews, 2014.
- “Autologous growth factor injections in chronic tendinopathy,” Sandrey, Journal of Athletic Training, 2014.
- “Popular Blood Therapy May Not Work,” Gina Kolata, New York Times.
- “Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis,” Han et al, Pain Med, 2019.
- “The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment,” Chen et al, American Journal of Sports Medicine, 2018.
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