PTOTMeta-AnalysisArchives of physiotherapy2019

The effects of regenerative injection therapy compared to corticosteroids for the treatment of lateral Epicondylitis: a systematic review and meta-analysis.

Julie Barnett, Madison N Bernacki, Jessica L Kainer and 3 others

PMID 31754461

WHAT IT FOUND

Autologous blood or platelet rich plasma injections for tennis elbow matched corticosteroids for pain at 1 and 2 months, then showed less pain and better arm use at 3 months, 6 months, and 1 year.

Key findings

01Autologous blood or platelet rich plasma injections did not differ from corticosteroid injections for pain at 1 or 2 months.

02Autologous blood or platelet rich plasma injections showed lower pain than corticosteroid injections at 3 and 6 months.

03Autologous blood or platelet rich plasma injections showed better self-reported upper limb use than corticosteroid injections at 3 months, 6 months, and 1 year.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The included trials had unclear or missing information about random allocation, allocation concealment, blinding of personnel, and blinding of outcome assessment. The regenerative injections were not standardized across studies, and prior or multiple injections were not controlled in some studies. Only three of the nine trials reported exercise prescription after injection, so it is unclear how much of the functional improvement came from rehab rather than the injection. The search was limited to English papers published between June 2008 and May 2018, so relevant trials may have been missed. The pooled results varied across studies, so the overall estimate should be read cautiously.

The easy way to misread this

Do not read this as proof that autologous blood or platelet rich plasma injections are better than corticosteroid injections for everyone with tennis elbow. The pooled pain and function results showed no early advantage over corticosteroids, and the later advantage came from trials that varied a lot and had unclear blinding and allocation.

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