Abstract
Background: Corticosteroids (CS) have shown good short-term performance in terms of pain relief
and functional improvement. However, the safety and long-term efficacy of this treatment remains
controversial. Several studies have reported good results of platelet-rich plasma (PRP) in the
treatment of tendinopathies. However, whether its use in the treatment of lateral epicondylitis (LE)
is superior to that of CS remains controversial.
Purpose: To perform a systematic review and meta-analysis of original studies to determine
whether the prognosis of LE patients treated with PRP is better than that of CS.
Study design: Meta-analysis; Level of evidence, 2.
Methods: Two independent reviewers searched online databases from January 2000 to July 2022
according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
guidelines to evaluate prospective studies of PRP versus CS injection for LE. A third author
addressed any discrepancies. Evidence quality was assessed using the Cochrane risk of bias tool.
Risk ratios for dichotomous variables and mean differences (MDs) for continuous variables were
used to compare clinical outcomes. P values <.05 were considered statistically significant.
Results: Eleven randomized controlled trials with 730 patients were included in this review. PRP
provided a significantly worse short-term (<2 months) improvement in the visual analog scale (VAS)
pain score (MD, 0.93 [95% CI, 0.42 to 1.44]; I = 85%; P = .0003) and Disabilities of the Arm,
Shoulder and Hand (DASH) score (MD, 10.23 [95% CI, 9.08 to 11.39]; I = 67%; P < .0001) but
better long-term (≥6 months) improvement in the VAS score (MD, -2.18 [95% CI, -3.13 to -1.22]; I
= 89%; P < .0001), DASH score (MD, -8.13 [95% CI, -9.87 to -6.39]; I = 25%; P < .0001), and Mayo
Elbow Performance Score (MD, 16.53 [95% CI, 1.52 to 31.53]; I = 98%; P = .03) than CS. The
medium-term (2-6 months) reduction in the VAS score was not significantly different between the
2 groups. After sensitivity analysis, none of the results changed except for the short-term VAS
scores (MD, 0.53 [95% CI, -0.13 to 1.19]; I = 78%; P = .12).
Conclusion: Both PRP and CS injections are effective treatments for patients with LE. CS provides
better short-term (<2 months) functional improvement and may be more advantageous in terms of
short-term pain relief, while PRP provides better long-term (≥6 months) functional improvement
and better performance regarding long-term pain relief.
Keywords: corticosteroid; lateral epicondylitis; meta-analysis; platelet-rich plasma.
Related information
GEO Profiles
MedGen
LinkOut – more resources
Full Text Sources
Atypon
Ovid Technologies, Inc.
Medical
MedlinePlus Health Information
Research Materials
NCI CPTC Antibody Characterization Program
Miscellaneous
NCI CPTAC Assay Portal