Platelet-Rich Plasma Vs Autologous Blood Vs Corticosteroid Injections in the Treatment of Lateral Epicondylitis: A Systematic Review, Pairwise and Network Meta-Analysis of Randomized Controlled Trials.

Only two of the 20 trials had low risk of bias, while 18 had unclear or high risk of bias. Blinding was difficult, and outcome assessor blinding was clearly reported in only 6 of 20 studies. Injection protocols, doses, and platelet-rich plasma leukocyte content varied across trials, so results cannot be applied to one specific product or technique. Some injections included lidocaine or bupivacaine, so the effect of corticosteroid, autologous blood, or platelet-rich plasma alone cannot be separated from the local anesthetic. Follow-up was uneven, with only one article reporting outcomes 1 year after treatment, and 2-month results combined with longer-term results. There were not enough data for a comprehensive adverse-effect analysis, and differences between study groups such as age and gender could not be explored.

The study was funded by the National Natural Science Foundation of China. The supplied text does not report additional author conflicts of interest.

Do not conclude that platelet-rich plasma or corticosteroid injection is proven best for every patient with tennis elbow. Most comparisons showed no clear difference, many trials had unclear or high risk of bias, injection preparations varied, and some injections also included local anesthetic, so the effect of the named treatment alone cannot be separated.