Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review

Br J Sports Med. 2014 Jun;48(12):952-6. doi: 10.1136/bjsports-2013-093281. Epub 2014 Feb 21.

Abstract

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.

Keywords: Elbow Injuries; Intervention Efficacy; Orthopaedics; Sporting Injuries; Tendons.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Chronic Disease
  • Evidence-Based Medicine
  • Humans
  • Injections
  • Platelet-Rich Plasma*
  • Tennis Elbow / therapy*
  • Treatment Outcome