Liu 2022 | Lat. Epicondylitis | Review
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Liu WC, Chen CT, Lu CC, Tsai YC, Liu YC, Hsu CW, Shih CL, Chen PC, Fu YC. Extracorporeal Shock Wave Therapy Shows Superiority Over Injections for Pain Relief and Grip Strength Recovery in Lateral Epicondylitis: A Systematic Review and Network Meta-analysis. Arthroscopy. 2022 Jun;38(6):2018-2034.e12.
Systematic review and Meta-analysis 40 RCTs were included evaluating ESWT and five different injection therapies • 10 trials of ESWT, 17 trials of corticosteroids (CS), 6 trials of botulinum toxin A (BoNTA), 10 trials of platelet-rich plasma (PRP), 4 trials of dextrose prolotherapy (DPT). Results: • DPT, ESWT , PRP, and BoNT-A were all significantly more efficacious than placebo for short-term pain relief ; • ESWT was significantly more efficacious than placebo for medium- term pain relief, while PRP was significantly less efficacious. • Among all treatment modalities, DPT was ranked as the most optimal short-term and medium-term pain reliever (SUCRA, 87.3% and 98.6%, respectively). • ESWT was ranked as the most optimal short-term and medium- term grip strength recovery (SUCRA; 79.4% and 86.4%, respectively). • Considering DASH scores and PRTEE scores as a tool for evaluating functional recovery, DPT (resp SUCRA = 73.8% and 86.5%) ranked the best among treatment options.
Key message DPT and ESWT were the best two treatment options for pain control and ESWT was the best treatment option for grip strength recovery.
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