The concentration of platelets in PRP does not affect pain outcomes in lateral epicondylitis: a systematic review and meta-analysis

Abstract

Aim: To investigate the analyze the relationship between concentration platelet-dose in platelet-rich plasma (PRP) injections and improvements in pain when treating lateral epicondylitis. Methods: A systematic review was conducted into five medical databases, exploring the difference in pain outcomes based on concentration of PRP. Results: Initial querying of the databases yielded 1408 articles with 20 articles ultimately included. There was no statistical significance between effect sizes of the two treatment groups (high and low platelet concentration; p = 0.976). Conclusion: Both large and small concentrations of platelets depict significant reduction in pain, however, between subgroups there was no significance. It can thus be concluded that concentration of platelets in PRP does not impact overall pain relief.

Article highlights

• Lateral epicondylitis is one of the most common presentations of nontraumatic elbow pain.

• Platelet-rich plasma (PRP) is a plasma-concentrated fraction of whole blood that contains cytokines with vast clinical applications.

• Optimal therapeutic concentration of platelets in PRP has yet to be elucidated in previous literature studies.

• A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines utilizing five medical databases (PubMed, Embase, Scopus, Web Of Science and Cochrane Library) exploring the difference in patient outcomes based on the concentration of PRP. 1408 articles initially pulled were reviewed and only 20 were ultimately included in the study.

• There was no statistical significance between effect sizes of the two treatment groups (high and low platelet concentration; p = 0.89).

• Through our systematic review of the current literature, we were able to conclude that the use of PRP injections in the management of lateral epicondylitis showed significant improvements in pain.

• The limitations of the evidence used in this study leave open to question the importance of PRP concentrations during procedures as both high and low concentrations were shown to be effective at improving pain.

Keywords: :

• Bone and cartilage
• growth factors
• pain
• regeneration

Supplemental material

Supplemental data for this article can be accessed at https://doi.org/10.1080/17581869.2024.2360381

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.