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1. Rabago D, Best TM, Zgierska AE, Zeisig E, Ryan M, Crane D: A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma. Br J Sports Med; 2009 Jul;43(7):471-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma.
  • 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.

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  • (PMID = 19028733.001).
  • [ISSN] 1473-0480
  • [Journal-full-title] British journal of sports medicine
  • [ISO-abbreviation] Br J Sports Med
  • [Language] ENG
  • [Grant] United States / NCCIH NIH HHS / AT / AT001879-02; United States / NCCIH NIH HHS / AT / K23 AT001879-03; United States / NCCIH NIH HHS / AT / K23 AT001879-01; United States / NCCIH NIH HHS / AT / AT001879-04; United States / NCCIH NIH HHS / AT / AT001879-05; United States / NCCIH NIH HHS / AT / K23 AT001879-05; United States / NCCIH NIH HHS / AT / AT001879-01; United States / NCCIH NIH HHS / AT / K23 AT001879-04; United States / NCCIH NIH HHS / AT / K23 AT001879-02; United States / NCCIH NIH HHS / AT / AT001879-03
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Sclerosing Solutions; 0AWH8BFG9A / polidocanol; 30IQX730WE / Polyethylene Glycols
  • [Number-of-references] 68
  • [Other-IDs] NLM/ NIHMS113468; NLM/ PMC2755040
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