Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Sports Medicine, The Hague Medical Centre, Antoniushove, Leidschendam, The Netherlands Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands.
Department of Medicine, University of British Columbia, Vancouver, Canada.
Br J Sports Med. 2014 Jun;48(12):952-6. doi: 10.1136/bjsports-2013-093281. Epub 2014 Feb 21.
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.
背景:慢性外侧肱骨上髁肌腱病在运动员中很常见,富血小板血浆(PRP)在其治疗中的应用越来越多。
目的:系统评价 PRP 注射治疗慢性外侧肱骨上髁肌腱病的疗效。
方法:2013 年 10 月,检索了 PubMed、EMBASE、CINAHL、Medline OvidSP、Scopus、Google Scholar、Web of Science 和 Cochrane Library 数据库。纳入标准为临床诊断为慢性外侧肱骨上髁肌腱病、随机对照试验、PRP 注射干预和以疼痛和/或功能为衡量标准的结局测量。一位作者筛选检索结果,两位作者独立使用 Physiotherapy Evidence Database(PEDro)评分评估研究质量。PEDro 评分为≥6 分的研究被认为是高质量的。采用最佳证据综合法确定证据水平。
结果:共纳入 6 项研究,其中 4 项被认为是高质量的。3 项高质量研究(75%)和 2 项低质量研究显示,与对照组相比,在最终随访测量或预先设定的主要结局评分时,没有显著获益。1 项高质量研究(25%)显示 PRP 注射与皮质类固醇注射相比具有有益的效果(皮质类固醇注射对肌腱病有害)。基于最佳证据综合,有强有力的证据表明 PRP 注射对慢性外侧肱骨上髁肌腱病无效。
结论:有强有力的证据表明 PRP 注射对慢性外侧肘肌腱病的治疗无效。
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