title: Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials.
abstract: Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE.
  
  
  
  A systematic search of the literature was conducted to identify related articles published from January 1980 to September 2016 in Pubmed, Embase, the Cochrane Library and SpringerLink. All studies that compared PRP with steroid administration on LE were included. Main outcomes were collected and analyzed by the Review Manager 5.1.
  
  
  
  Eight randomized controlled trials (RCTs) that involved 511 patients met the criteria. This meta-analysis showed that there was no significant difference in pain relief in the short-term (2 to 4 weeks: SMD = 1.02, P = .03; 6 to 8 weeks: SMD = .73, P = .24) and the intermediate-term (12 weeks: SMD = -0.28, P = .35). Steroid exhibited a better efficacy of function in the short-term (2 to 4 weeks: SMD = .61, P < .001; 6 to 8 weeks: SMD = .53, P < .001). However, PRP was superior to steroid for pain relief in the long-term (half year: SMD = -1.6, P < .001; one year: SMD = -1.45, P < .001), and also for function improving in the intermediate-term (12 weeks: SMD = -0.53, P < .001) and the long-term (half year: SMD = -0.56, P < .001; one year: SMD = -0.7, P < .001). No serious adverse effects of treatment were observed in the two groups.
  
  
  
  Treatment of patients with LE by steroid could slightly relieve pain and significantly improve function of elbow in the short-term (2 to 4 weeks, 6 to 8 weeks). PRP appears to be more effective in relieving pain and improving function in the intermediate-term (12 weeks) and long-term (half year and one year). Considering the long-term effectiveness of PRP, we recommend PRP as the preferred option for LE.
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Bobin
authors.initials: B
authors.lastname: Mi
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Guohui
authors.initials: G
authors.lastname: Liu
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Wu
authors.initials: W
authors.lastname: Zhou
authors.affiliation: b Department of Rheumatology , Tangdu Hospital, The Fourth Military Medical University , Xi'an , China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Lv
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Qipeng
authors.initials: Q
authors.lastname: Wu
authors.affiliation: a Department of Orthopedics , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004550:Elbow / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010146:Pain; D059408:Pain Management; D053657:Platelet-Rich Plasma; D013256:Steroids / Q000627:therapeutic use; D052256:Tendinopathy / Q000628:therapy; D013716:Tennis Elbow / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013256:Steroids; D008775:Methylprednisolone
keywords: Lateral epicondylitis; meta-analysis; platelet rich plasma; steroid