The safety and effectiveness of autologous platelet-rich plasma therapy for lateral epicondylitis: a systematic review

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Kim SY1
1National Evidence-Based Collaborating Agency, South Korea
Abstract
Background: Lateral epicondylitis, is a common musculoskeletal disorder for which a safe and effective treatment strategy remains unknown.

Objectives: To evaluate the safety and effectiveness of platelet-rich plasma (PRP) therapy for lateral epicondylitis.

Methods: The literature review covered the period from 10 September 2015 to 7 October 2015, and eight Korean databases and foreign databases including Ovid-MEDLINE, EMBASE, and Cochrane Library were used. The outcomes of interest were pain (as measured by visual analogue scale (VAS) or Nirschl score), functional scores (as measured by Disabilities of the Arm, Shoulder and Hand Scale (DASH) or others), quality of life and complications. Two reviewers independently assessed the quality of the included studies and extracted data. The quality of the studies was assessed according to the Scottish Intercollegiate Guidelines Network (SIGN) tool.

Results: Eleven studies fitted the inclusion criteria. Of these, seven were randomized controlled trials (RCTs) and four were prospective cohort studies. Some studies showed that the VAS for pain improved significantly from pre-injection to the follow-up in the PRP and control groups. Complications outcomes were rare. However, the results of pain (Nirschl score), function score were inconsistent, and superiority of PRP over control treatments could not be conclusively demonstrated.

Conclusions: PRP is a safe and promising treatment of lateral epicondylitis. However, its superiority over other treatment remains unproven. Also there are no established protocols (e.g. volume, number, interval of injection) for PRP treatment. Therefore more studies are needed to confirm effectiveness of PRP.