Department of Orthopedic Surgery, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea.
J Shoulder Elbow Surg. 2022 Feb;31(2):428-436. doi: 10.1016/j.jse.2021.09.008. Epub 2021 Oct 14.
Although surgical treatment is considered reliable for lateral elbow tendinosis, local injection therapy may be preferable, as it avoids surgery. Among a number of local injections, platelet-rich plasma has been used successfully to treat lateral elbow tendinosis. The purpose of this study was to compare the outcomes in patients treated with either platelet-rich plasma injections or surgery for lateral elbow tendinosis using a systematic literature review and meta-analysis.
MEDLINE, Embase, and Cochrane Library databases were systematically searched for studies published before March 1, 2021, that compared platelet-rich plasma with operative treatment for lateral elbow tendinosis. The pooled analysis was designed to compare the visual analog scale scores and the Patient-Related Tennis Elbow Evaluation scores between the platelet-rich plasma and surgical treatment groups at serial time points.
We included 5 studies involving 340 patients with lateral elbow tendinosis, comprising of 154 patients treated with platelet-rich plasma and 186 patients who underwent surgical treatment. The pooled analysis showed no statistically significant differences in the visual analog scale scores at any of the follow-up time points, namely, 2 months (mean difference [MD] 1.11, 95% confidence interval [CI] -2.51 to 4.74, P = .55, I = 94%), 6 months (MD 0.80, 95% CI -2.83 to 4.42, P = .67, I = 92%), and 12 months (MD -0.92, 95% CI -4.63 to 2.80, P = .63, I = 93%) postintervention and in the Patient-Related Tennis Elbow Evaluation scores at 12 weeks (MD -1.86, 95% CI -22.30 to 18.58, P = .86, I = 81%), 24 weeks (MD -3.33, 95% CI -21.82 to 15.17, P = .72, I = 74%), and 52 weeks (MD -3.64, 95% CI -19.65 to 12.37, P = .66, I = 69%) postintervention.
Local platelet-rich plasma injections and surgical treatment produced equivalent pain scores and functional outcomes in patients with lateral elbow tendinosis. Thus, platelet-rich plasma injections may represent a reasonable alternative treatment for patients who are apprehensive to proceed with surgery or for poor surgical candidates.
尽管手术治疗被认为是治疗外侧肘肌腱病的可靠方法，但局部注射疗法可能更为可取，因为它避免了手术。在许多局部注射中，富血小板血浆已成功用于治疗外侧肘肌腱病。本研究的目的是通过系统文献回顾和荟萃分析比较使用富血小板血浆注射或手术治疗外侧肘肌腱病的患者的结果。
系统检索了 MEDLINE、Embase 和 Cochrane 图书馆数据库，以获取截至 2021 年 3 月 1 日发表的比较富血小板血浆与手术治疗外侧肘肌腱病的研究。荟萃分析旨在比较富血小板血浆组和手术治疗组在连续时间点的视觉模拟量表评分和患者相关网球肘评估评分。
我们纳入了 5 项研究，共纳入 340 例外侧肘肌腱病患者，其中 154 例接受富血小板血浆治疗，186 例接受手术治疗。荟萃分析显示，在任何随访时间点，视觉模拟量表评分均无统计学意义上的差异，即 2 个月（平均差值 [MD] 1.11，95%置信区间 [CI] -2.51 至 4.74，P =.55，I = 94%）、6 个月（MD 0.80，95% CI -2.83 至 4.42，P =.67，I = 92%）和 12 个月（MD -0.92，95% CI -4.63 至 2.80，P =.63，I = 93%）时，以及在术后 12 周的患者相关网球肘评估评分（MD -1.86，95% CI -22.30 至 18.58，P =.86，I = 81%）、24 周（MD -3.33，95% CI -21.82 至 15.17，P =.72，I = 74%）和 52 周（MD -3.64，95% CI -19.65 至 12.37，P =.66，I = 69%）时，无统计学意义上的差异。
局部富血小板血浆注射和手术治疗在外侧肘肌腱病患者中产生了等效的疼痛评分和功能结果。因此，富血小板血浆注射可能是对手术有顾虑或手术候选者较差的患者的合理替代治疗方法。
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