Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 16. J Sport Rehabil. 2016 Feb;25(1):77-82. doi: 10.1123/jsr.2014-0198. Epub 2014 Dec 4. Platelet-Rich Plasma Compared With Other Common Injection Therapies in the Treatment of Chronic Lateral Epicondylitis. Rodik T(1), McDermott B. Author information: (1)Missouri Southern State University, Joplin, MO. CLINICAL SCENARIO: Lateral epicondylitis (LE) is a relatively common pathology capable of producing chronic debilitation in a variety of patients. A newer treatment for orthopedic conditions is platelet-rich plasma (PrP) local injection. FOCUSED CLINICAL QUESTION: Is PrP a more appropriate injection therapy for LE than other common injections such as corticosteroid or whole blood? SUMMARY OF KEY FINDINGS: Four studies were included: 1 randomized controlled trial (RCT), 2 double-blind RCTs, and 1 cohort study. Two studies involved comparisons of PrP injection to corticosteroid injection. One of the studies involved a 2-y follow-up while another involved a 1-y follow-up. Another study involved the comparison of PrP injection with whole-blood injection with a 6-mo follow-up. The final study included a PrP-injection group and control group. The 2 studies involving PrP vs. corticosteroid injections with 2-y and 1-y follow-ups both favored PrP over corticosteroid injection in terms of pain reduction and function increases. The third study favored PrP injections over whole-blood injections at 6 mo regarding pain reduction. All studies demonstrated significant improvements with PrP over comparison injections or no injection. Clinical Bottom Line: PrP injections provide more favorable pain and function outcomes than whole blood and corticosteroid injections for 1-2 y after injection. STRENGTH OF RECOMMENDATION: Consistent findings from RCTs suggest level 1b evidence in support of PrP injection as a treatment for LE. DOI: 10.1123/jsr.2014-0198