A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma

File Size Format
74903_1.pdf 230Kb Adobe PDF View
Title A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma
Author Rabago, D.; Best, T.M.; Zgierska, A.E.; Zeisig, E.; Ryan, Michael; Crane, D.
Journal Name British Journal of Sports Medicine
Year Published 2009
Place of publication United Kingdom
Publisher BMJ Group
Abstract Objective: To appraise existing evidence for prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injection therapies for lateral epicondylosis (LE). Design: Systematic review. Data sources: Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine. Search strategy: names and descriptors of the therapies and LE. Study Selection: All human studies assessing the four therapies for LE. Main results: Results of five prospective case series and four controlled trials (three prolotherapy, two polidocanol, three autologous whole blood and one platelet-rich plasma) suggest each of the four therapies is effective for LE. In follow-up periods ranging from 9 to 108 weeks, studies reported sustained, statistically significant (p<0.05) improvement in visual analogue scale primary outcome pain score measures and disease-specific questionnaires; relative effect sizes ranged from 51% to 94%; Cohen’s d ranged from 0.68 to 6.68. Secondary outcomes also improved, including biomechanical elbow function assessment (polidocanol and prolotherapy), presence of abnormalities and increased vascularity on ultrasound (autologous whole blood and polidocanol). Subjects reported satisfaction with therapies on single-item assessments. All studies were limited by small sample size. Conclusions: There is strong pilot-level evidence supporting the use of prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injections in the treatment of LE. Rigorous studies of sufficient sample size, assessing these injection therapies using validated clinical, radiological and biomechanical measures, and tissue injury/healing-responsive biomarkers, are needed to determine long-term effectiveness and safety, and whether these techniques can play a definitive role in the management of LE and other tendinopathies.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1136/bjsm.2008.052761
Copyright Statement Copyright remains with the authors 2009. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal’s website or contact the authors.
Volume 43
Issue Number 7
Page from 471
Page to 481
ISSN 0306-3674
Date Accessioned 2012-01-04
Language en_US
Research Centre Centre for Musculoskeletal Research
Faculty Griffith Health Faculty
Subject Complementary and Alternative Medicine; Regenerative Medicine (incl Stem Cells and Tissue Engineering); Sports Medicine
URI http://hdl.handle.net/10072/41932
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

Show simple item record

Griffith University copyright notice