Injection therapies for lateral epicondylalgia: a systematic review and Bayesian network meta-analysis
| Autor: | Kong Fanlin, Zeng-Li Wang, Xiang-Bo Lin, Christof Burger, Kristian Welle, Zhi-Chao Jiang, H. Goost, Christian Paul, Dong Wei, Koroush Kabir |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Anti-Inflammatory Agents MEDLINE Physical Therapy Sports Therapy and Rehabilitation Placebo Injections Intra-Articular law.invention Autologous blood injection Young Adult 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Randomized controlled trial law Tennis elbow medicine Humans Orthopedics and Sports Medicine Watchful Waiting Aged Randomized Controlled Trials as Topic 030222 orthopedics business.industry Prolotherapy Tennis Elbow Bayes Theorem 030229 sport sciences General Medicine Middle Aged medicine.disease Arthralgia Sample size determination Meta-analysis Physical therapy business |
| Zdroj: | British Journal of Sports Medicine. 50:900-908 |
| ISSN: | 1473-0480 0306-3674 |
| Popis: | Background There are many injection therapies for lateral epicondylalgia but there has been no previous comprehensive comparison, based on the Bayesian method. Methods The MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for appropriate literature. The outcome measurement was the pain score. Direct comparisons were performed using the pairwise meta-analysis, and network meta-analysis, based on a Bayesian model, was used to calculate the results of all of the potentially possible comparisons and rank probabilities. A sensitivity analysis was performed by excluding low-quality studies. The inconsistency of the model was assessed by means of the node-splitting method. Metaregression was used to assess the relationship between the sample size and the treatment effect. Results All of the injection treatments showed a trend towards better effects than placebo. Additionally, the peppering technique did not add additional benefits when combined with other treatments. No significant changes were observed by excluding low-quality studies in the sensitivity analysis. No significant inconsistencies were found according to the inconsistency analysis, and metaregression revealed that the sample size was not associated with the treatment effects. Conclusions Some commonly used injection therapies can be considered treatment candidates for lateral epicondylalgia, such as botulinum toxin, platelet-rich plasma and autologous blood injection, but corticosteroid is not recommended. Hyaluronate injection and prolotherapy might be more effective, but their superiority must be confirmed by more research. The peppering technique is not helpful in injection therapies. |
| Databáze: | OpenAIRE |
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