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Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis

OBJECTIVE: The aim of this meta-analysis was to compare the effectiveness of platelet-rich plasma (PRP) vs corticosteroids for treatment of patients with lateral elbow epicondylitis. METHODS: A literature search was performed in EMBASE, Medline, the Cochrane Library and PubMed. Randomized controlled...

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Autores principales: Li, Ang, Wang, Hongbo, Yu, Zhenghong, Zhang, Guangquan, Feng, Shiqing, Liu, Liyun, Gao, Yanzheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940118/
https://www.ncbi.nlm.nih.gov/pubmed/31860992
http://dx.doi.org/10.1097/MD.0000000000018358
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author Li, Ang
Wang, Hongbo
Yu, Zhenghong
Zhang, Guangquan
Feng, Shiqing
Liu, Liyun
Gao, Yanzheng
author_facet Li, Ang
Wang, Hongbo
Yu, Zhenghong
Zhang, Guangquan
Feng, Shiqing
Liu, Liyun
Gao, Yanzheng
author_sort Li, Ang
collection PubMed
description OBJECTIVE: The aim of this meta-analysis was to compare the effectiveness of platelet-rich plasma (PRP) vs corticosteroids for treatment of patients with lateral elbow epicondylitis. METHODS: A literature search was performed in EMBASE, Medline, the Cochrane Library and PubMed. Randomized controlled studies comparing PRP with corticosteroids for the treatment of epicondylitis were included. The Cochrane Collaboration's tool for assessing the risk of bias was used to evaluate the methodological quality of the included trials. The Cochrane Collaboration's Review Manager software was used to perform the meta-analyses. The overall effect size of each anesthetic was calculated as the weighted average of the inverse variance of the study-specific estimates. RESULTS: Seven randomized controlled trials were included in this review. The data from 2 studies were unavailable for meta-analysis, and the systematic review criteria were just achieved. Local corticosteroid injection yielded a significantly superior Disabilities of the Arm, Shoulder and Hand (DASH) score at 4 weeks (WMD, 11.90; 95% CI: 7.72 to 16.08; P < .00001; heterogeneity, χ(2) = 0, I(2) = 0%, P = 1.00) and 8 weeks (WMD, 6.29; 95% CI: 2.98 to 9.60; P = .0002, χ(2) = 0, I(2) = 0%, P = 1.00). Otherwise, it was noteworthy that a significantly lower VAS score (WMD, −2.61; 95% CI: −5.18 to −0.04; P = .05; heterogeneity, χ(2) = 29.85, I(2) = 97%, P < .00001) and DASH score (WMD, −7.73; 95% CI: −9.99 to −5.46; P < .00001, χ(2) = 0.20, I(2) = 0%, P = .66) existed in the PRP regimen than in the steroid regimen at the 24-week follow-up. More effective treatments were achieved in the PRP-treated patients than in the patients treated with corticosteroids (WMD, 3.33; 95% CI: 1.81 to 6.14; P = .000; heterogeneity, χ(2) = 0.43, I(2) = 0%, P = .51). CONCLUSIONS: Local corticosteroid injections demonstrated favorable outcomes compared with those of local PRP treatments for lateral elbow epicondylitis during the short-term follow-up period (4 weeks and 8 weeks post-treatment). Otherwise, at the long-term follow-up (24 weeks post-treatment), PRP injections had improved pain and function more effectively than corticosteroid injections.
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spelling pubmed-69401182020-01-31 Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis Li, Ang Wang, Hongbo Yu, Zhenghong Zhang, Guangquan Feng, Shiqing Liu, Liyun Gao, Yanzheng Medicine (Baltimore) 7100 OBJECTIVE: The aim of this meta-analysis was to compare the effectiveness of platelet-rich plasma (PRP) vs corticosteroids for treatment of patients with lateral elbow epicondylitis. METHODS: A literature search was performed in EMBASE, Medline, the Cochrane Library and PubMed. Randomized controlled studies comparing PRP with corticosteroids for the treatment of epicondylitis were included. The Cochrane Collaboration's tool for assessing the risk of bias was used to evaluate the methodological quality of the included trials. The Cochrane Collaboration's Review Manager software was used to perform the meta-analyses. The overall effect size of each anesthetic was calculated as the weighted average of the inverse variance of the study-specific estimates. RESULTS: Seven randomized controlled trials were included in this review. The data from 2 studies were unavailable for meta-analysis, and the systematic review criteria were just achieved. Local corticosteroid injection yielded a significantly superior Disabilities of the Arm, Shoulder and Hand (DASH) score at 4 weeks (WMD, 11.90; 95% CI: 7.72 to 16.08; P < .00001; heterogeneity, χ(2) = 0, I(2) = 0%, P = 1.00) and 8 weeks (WMD, 6.29; 95% CI: 2.98 to 9.60; P = .0002, χ(2) = 0, I(2) = 0%, P = 1.00). Otherwise, it was noteworthy that a significantly lower VAS score (WMD, −2.61; 95% CI: −5.18 to −0.04; P = .05; heterogeneity, χ(2) = 29.85, I(2) = 97%, P < .00001) and DASH score (WMD, −7.73; 95% CI: −9.99 to −5.46; P < .00001, χ(2) = 0.20, I(2) = 0%, P = .66) existed in the PRP regimen than in the steroid regimen at the 24-week follow-up. More effective treatments were achieved in the PRP-treated patients than in the patients treated with corticosteroids (WMD, 3.33; 95% CI: 1.81 to 6.14; P = .000; heterogeneity, χ(2) = 0.43, I(2) = 0%, P = .51). CONCLUSIONS: Local corticosteroid injections demonstrated favorable outcomes compared with those of local PRP treatments for lateral elbow epicondylitis during the short-term follow-up period (4 weeks and 8 weeks post-treatment). Otherwise, at the long-term follow-up (24 weeks post-treatment), PRP injections had improved pain and function more effectively than corticosteroid injections. Wolters Kluwer Health 2019-12-20 /pmc/articles/PMC6940118/ /pubmed/31860992 http://dx.doi.org/10.1097/MD.0000000000018358 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 7100
Li, Ang
Wang, Hongbo
Yu, Zhenghong
Zhang, Guangquan
Feng, Shiqing
Liu, Liyun
Gao, Yanzheng
Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title_full Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title_fullStr Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title_full_unstemmed Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title_short Platelet-rich plasma vs corticosteroids for elbow epicondylitis: A systematic review and meta-analysis
title_sort platelet-rich plasma vs corticosteroids for elbow epicondylitis: a systematic review and meta-analysis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940118/
https://www.ncbi.nlm.nih.gov/pubmed/31860992
http://dx.doi.org/10.1097/MD.0000000000018358
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