Facultad de Medicina y Hospital Universitario Dr. Jose Eleuterio Gonzalez, Orthopedics and Traumatology Service, Universidad Autonoma de Nuevo Leon, Av. Francisco. I. Madero and Dr. José Eleuterio González s/n, Colonia Mitras Centro, 64460, Monterrey, Nuevo León, Mexico.
Facultad de Medicina, Plataforma Invest-KER Unit Mexico, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
Clin Rheumatol. 2020 Aug;39(8):2255-2265. doi: 10.1007/s10067-020-05000-y. Epub 2020 Feb 26.
To compare the effects of platelet-rich plasma (PRP) injection versus placebo (saline injection) on pain and joint function in lateral epicondylitis in randomized placebo-controlled trials. Randomized controlled trials that evaluated pain (visual analog scale [VAS] and patient-rated tennis elbow evaluation [PRTEE]) and/or functional improvement (PRTEE; disability of the arm, shoulder, and hand [DASH]; and Roles-Maudsley score [RMS]) in patients diagnosed with lateral epicondylitis and compared PRP with placebo injections were considered. The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched from inception to October 2019. The assessment of bias was performed using the Cochrane Risk of Bias Tool version 1. The meta-analysis was conducted with a random effects model and generic inverse variance method. Five trials involving a total of 276 individuals were included. They used a parallel study design and saline solution as placebo. The mean age of participants was 48.0 ± 9.3 years. Follow-up varied from 2 months to 1 year. No significant changes were noted for pain (standardized mean difference [SMD], - 0.51 [95% confidence interval (CI), - 1.32 to - 0.30]) nor functional scores (SMD, - 0.07 [95% CI, - 0.46 to 0.33]) between PRP and placebo injections. The most frequent adverse reaction reported in two of the five studies was transient post-injection pain for a few days (from 16 to 20% in the PRP group and from 8 to 16% in the placebo group). PRP injection was not superior to placebo for relieving pain and joint functionality in chronic lateral epicondylitis. However, patients reported improvement after both interventions in such clinical parameters. Further randomized trials are required to determine whether PRP injection is clinically more effective than placebo (saline injection).
比较富血小板血浆 (PRP) 注射与安慰剂（生理盐水注射）治疗外侧肱骨上髁炎的疼痛和关节功能的随机安慰剂对照试验。纳入评估疼痛（视觉模拟量表 [VAS] 和患者自评网球肘评估 [PRTEE]）和/或功能改善（PRTEE；手臂、肩部和手的残疾程度 [DASH]；和 Roles-Maudsley 评分 [RMS]）的随机对照试验，比较 PRP 与安慰剂注射。检索 MEDLINE、EMBASE、Web of Science 和 Scopus 数据库，检索时间从建库至 2019 年 10 月。使用 Cochrane 偏倚风险工具版本 1 评估偏倚。使用随机效应模型和通用倒数方差法进行荟萃分析。纳入 5 项共 276 名参与者的试验，采用平行研究设计，盐水溶液作为安慰剂。参与者的平均年龄为 48.0±9.3 岁。随访时间从 2 个月到 1 年不等。PRP 与安慰剂注射相比，疼痛（标准化均数差 [SMD]，-0.51 [95%置信区间（CI），-1.32 至-0.30]）和功能评分（SMD，-0.07 [95% CI，-0.46 至 0.33]）均无显著变化。在 5 项研究中的 2 项研究中，报告最常见的不良反应是注射后几天内短暂的注射后疼痛（PRP 组为 16%至 20%，安慰剂组为 8%至 16%）。PRP 注射在缓解慢性外侧肱骨上髁炎的疼痛和关节功能方面并不优于安慰剂。然而，患者报告在这两种干预措施后，这些临床参数都有所改善。需要进一步的随机试验来确定 PRP 注射是否比安慰剂（生理盐水注射）在临床上更有效。
