title: Efficacy of platelet-rich plasma injections in pain associated with chronic tendinopathy: A systematic review.
abstract: BACKGROUND
  Chronic tendinopathy has often been a management dilemma for general practitioners. With our understanding of the pathophysiology of tendinopathy evolving, so has our management, with the advent of newer strategies such as topical glycerol trinitrate, extracorporeal shock-wave therapy, as well as platelet-rich plasma (PRP).
  
  
  OBJECTIVE
  To systematically review the literature regarding PRP therapy in chronic tendinopathy.
  
  
  METHODS
  The databases used in our search include the Elton B. Stephens Co. (EBSCO) database, Medline, the Cochrane library, Ovid, and Embase (the Excerpta Medica database). A total of 389 articles were reviewed from Feb 2010 to April 2014, for possible inclusion. Of these articles, a total of 9 randomized controlled trials (RCTs) met our inclusion criteria. Only 1 RCT was excluded due to previous surgery in both the trial and control groups.
  
  
  METHODS
  Each article was reviewed independently by 2 authors. Each article was analyzed using the Cochrane Criteria checklist. Where any discrepancy occurred in results, a third independent reviewer was consulted.
  
  
  RESULTS
  Our review found that PRP was most effective in patellar and lateral epicondylar tendinopathy, with both RCTs in the patellar section of our study supporting the use of PRP in pain reduction at 3 and 12 months, whereas 2 of 4 studies in the lateral epicondylar section showed improvements in pain and disability at 6 and 12 months. There was a lack of evidence to support the use of PRP in Achilles and rotator cuff tendinopathy.
  
  
  CONCLUSIONS
  Although the results of this review show promise for the use of PRP in chronic tendinopathy, the analysis highlighted the need for more controlled clinical trials comparing PRP with placebo.
authors.affiliation: a 1 St. Vincent's Hospital , Melbourne, Australia.
authors.forename: Umatheepan
authors.initials: U
authors.lastname: Balasubramaniam
authors.forename: Ravi
authors.initials: R
authors.lastname: Dissanayake
authors.forename: Lucas
authors.initials: L
authors.lastname: Annabell
mesh_terms: D000125:Achilles Tendon; D059350:Chronic Pain / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007267:Injections; D053657:Platelet-Rich Plasma; D017006:Rotator Cuff; D052256:Tendinopathy / Q000150:complications / Q000628:therapy*
keywords: Chronic tendinopathy; pain; platelet-rich plasma