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与皮质类固醇相比,再生注射疗法治疗外侧上髁炎的效果:一项系统评价和荟萃分析。

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

作者信息

Barnett Julie, Bernacki Madison N, Kainer Jessica L, Smith Hannah N, Zaharoff Annette M, Subramanian Sandeep K

机构信息

Department of Physical Therapy, School of Health Professions, UT Health San Antonio, 7703 Floyd Curl Drive, MSC 6247, San Antonio, TX 78229 USA.

The Non-Surgical Center of Texas, San Antonio, USA.

出版信息

Arch Physiother. 2019 Nov 13;9:12. doi: 10.1186/s40945-019-0063-6. eCollection 2019.

Abstract

BACKGROUND

The lateral epicondyle is a common site for chronic tendinosis (i.e. lateral epicondylitis), a condition characterized by overuse and degeneration of a tendon due to repeated microtrauma. This leads to pain and functional limitations. There is a growing interest in non-surgical forms of treatment for this condition including provision of corticosteroid injections and regenerative injection therapy (provision of autologous blood and platelet rich plasma injections).

OBJECTIVE

We compared the effectiveness of corticosteroids with regenerative injection therapy for the treatment of lateral epicondylitis.

METHODS

We systematically reviewed randomized controlled trials published in English language from 2008 to 2018. Databases used included PEDro, Scopus, PubMed, and CINAHL. Nine articles met our selection criteria. The PEDRo scale scores helped assess study quality. Cochrane risk of bias criteria helped assess bias. We analyzed results focusing on pain and function using meta-analyses.

RESULTS

Six out of 9 studies had low risk of bias. There were no short-term (1 and 2 month) differences in pain scores between the corticosteroid and regenerative injection groups. Participants receiving regenerative injections demonstrated greater long-term improvements lasting for a period of  years.

CONCLUSION

Regenerative injections provision results in greater long-term pain relief and improved function for people with lateral epicondylitis.

摘要

背景

外侧上髁是慢性肌腱病(即外侧上髁炎)的常见发病部位,该病的特征是由于反复微小创伤导致肌腱过度使用和退变,进而引起疼痛和功能受限。对于这种疾病,非手术治疗方式越来越受到关注,包括注射皮质类固醇和再生注射疗法(注射自体血和富含血小板血浆)。

目的

我们比较了皮质类固醇与再生注射疗法治疗外侧上髁炎的有效性。

方法

我们系统回顾了2008年至2018年以英文发表的随机对照试验。使用的数据库包括PEDro、Scopus、PubMed和CINAHL。9篇文章符合我们的入选标准。PEDro量表评分有助于评估研究质量。Cochrane偏倚风险标准有助于评估偏倚。我们使用荟萃分析聚焦于疼痛和功能分析结果。

结果

9项研究中有6项偏倚风险较低。皮质类固醇注射组和再生注射组在短期(1个月和2个月)疼痛评分上没有差异。接受再生注射的参与者在长达数年的长期随访中显示出更大的改善。

结论

对于外侧上髁炎患者,再生注射疗法能带来更持久的疼痛缓解和功能改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e99/6854772/027f310ef740/40945_2019_63_Fig1_HTML.jpg

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