Federal University of Bahia, Av. Reitor Miguel Calmon, S/N - Vale do Canela, Salvador, Bahia, 40110-100, Brazil.
Ernesto Simões Filho General Hospital, Salvador, Bahia, Brazil.
Int Orthop. 2024 Dec;48(12):3139-3149. doi: 10.1007/s00264-024-06339-6. Epub 2024 Sep 30.
This study aims to assess the efficacy of botulinum toxin type A (BT-A) in treating tennis elbow.
We systematically reviewed the literature and included full-text randomized clinical trials (RCTs) published until June 2024, available in PubMed, Scopus, Embase, and Cochrane CENTRAL databases. Eligible studies involved patients with tennis elbow and compared BT-A with placebo or other injectable treatments. Primary outcomes included pain relief, while secondary outcomes assessed quality of life, adverse effects, and grip strength. The risk of bias was evaluated using the Cochrane Risk of Bias tool.
Seven RCTs with a total of 381 patients were included. The participants were predominantly middle-aged (mean age 46.64 ± 7.72 years) and diagnosed with chronic tennis elbow. BT-A doses ranged from 20U to 60U. Compared to placebo, BT-A effectively reduced pain at two to four weeks (MD = -1.37; 95% CI = -2.18 to -0.57) and at eight to 12 weeks (MD = -1.13; 95% CI = -1.62 to -0.65). Grip strength was comparable between the BT-A and placebo groups at both time points (2 to 4 weeks: SMD = -0.86; 95% CI -1.78 to 0.05; 8 to 12 weeks: SMD = 0.00; 95% CI = -0.95 to 0.95).
This meta-analysis suggests that BT-A reduces pain in tennis elbow within two to 12 weeks compared to placebo. Findings are limited by study size, and further research is needed to confirm its efficacy and safety.
本研究旨在评估肉毒毒素 A（BT-A）治疗网球肘的疗效。
我们系统地检索了文献，并纳入了截至 2024 年 6 月在 PubMed、Scopus、Embase 和 Cochrane CENTRAL 数据库中发表的全文随机对照临床试验（RCT）。合格的研究涉及网球肘患者，并比较了 BT-A 与安慰剂或其他注射治疗。主要结局包括疼痛缓解，次要结局评估生活质量、不良反应和握力。使用 Cochrane 偏倚风险工具评估偏倚风险。
纳入了 7 项 RCT，共 381 名患者。参与者主要为中年（平均年龄 46.64±7.72 岁），诊断为慢性网球肘。BT-A 剂量范围为 20U 至 60U。与安慰剂相比，BT-A 在 2 至 4 周（MD=-1.37；95%CI=-2.18 至-0.57）和 8 至 12 周（MD=-1.13；95%CI=-1.62 至-0.65）时有效减轻疼痛。在这两个时间点，BT-A 和安慰剂组的握力均无差异（2 至 4 周：SMD=-0.86；95%CI=-1.78 至 0.05；8 至 12 周：SMD=0.00；95%CI=-0.95 至 0.95）。
这项荟萃分析表明，与安慰剂相比，BT-A 在 2 至 12 周内可减轻网球肘疼痛。研究规模有限，需要进一步研究以确认其疗效和安全性。
