Heartland Orthopedic Specialists, Alexandria, Minnesota, U.S.A..
University of Minnesota Morris, Morris, Minnesota, U.S.A.
Arthroscopy. 2021 Nov;37(11):3360-3367. doi: 10.1016/j.arthro.2021.04.043. Epub 2021 May 3.
To determine whether platelet-rich plasma (PRP) injection for lateral epicondylitis offers patients comparable outcomes to lateral epicondylar surgery.
Embase, Cochrane Library, and MEDLINE databases were searched using the terms lateral epicondylitis, lateral elbow pain, tennis elbow, lateral epicondylalgia, and elbow tendinopathy individually and combined with the terms platelet-rich plasma injections and lateral epicondylar surgery. We compared pain relief, function between the 2 treatment options, and identified whether PRP injection reduced the incidence of lateral epicondylar surgery. Studies must have compared PRP injections with lateral epicondylar surgery for the treatment of lateral epicondylitis; be of Level I, II, or III evidence; and be written in the English language.
Three studies (1 Level II and 2 Level III) met inclusion criteria. Two of the studies suggested that PRP injections offer similar relief as surgery in the short and mid-term, one study reported that PRP injections and surgery had similar outcomes in pain improvement and return to work, whereas 1 study reported that surgery may be a better long-term solution.
In comparison with lateral epicondylar surgery, PRP injections offer similar improvements in pain and function for patients suffering from lateral epicondylitis, especially in the short- and mid-term in 2 of the 3 included investigations. Therefore, PRP injections are an appropriate alternative for the treatment of lateral epicondylitis.
Level III, Systematic Review of Level III or greater evidence.
确定富血小板血浆(PRP)注射治疗外侧肱骨上髁炎是否能为患者提供与外侧肱骨上髁手术相当的疗效。
单独使用外侧肱骨上髁炎、外侧肘部疼痛、网球肘、外侧肱骨上髁痛和肘肌腱病等术语,并将其与富血小板血浆注射和外侧肱骨上髁手术等术语结合,在 Embase、Cochrane 图书馆和 MEDLINE 数据库中进行检索。我们比较了两种治疗选择的疼痛缓解和功能,并确定 PRP 注射是否降低了外侧肱骨上髁手术的发生率。研究必须将 PRP 注射与外侧肱骨上髁手术比较,用于治疗外侧肱骨上髁炎;为一级、二级或三级证据;并以英文书写。
有 3 项研究(1 项二级和 2 项三级)符合纳入标准。其中 2 项研究表明,PRP 注射在短期和中期提供与手术相似的缓解效果,1 项研究报告 PRP 注射和手术在疼痛改善和恢复工作方面具有相似的结果,而 1 项研究报告手术可能是一种更好的长期解决方案。
与外侧肱骨上髁手术相比,PRP 注射为外侧肱骨上髁炎患者提供了相似的疼痛和功能改善,尤其是在 3 项纳入研究中的 2 项研究中,在短期和中期。因此,PRP 注射是治疗外侧肱骨上髁炎的一种合适的替代方法。
三级,对三级或更高水平证据的系统评价。