Autologous blood injection for treatment of lateral epicondylosis: A meta-analysis of randomized controlled trials

Objectives: To appraise existing evidence of autologous blood injection in treating lateral epicondylosis. Design: Meta-analysis of randomized controlled trials. Setting: A comprehensive search of the PubMed, Cochrane, SCOPUS, and CINAHL databases was performed to identify randomized controlled trials that reported the efficacy of autologous blood injection in treating lateral epicondylosis. The selected studies were subjected to a meta-analysis and risk of bias assessment. Participants: Patients with lateral epicondylosis. Main Outcome Measures: Pain-related measurement in each selected randomized controlled trial was pooled into meta-analysis. Results: Nine randomized controlled trials were included in the analysis. The results of the meta-analysis including the pain scores indicated that autologous blood injection is more effective compared with corticosteroid injection (standard mean difference: -0.75; 95% confidence interval: -1.14 to -0.37) but not more effective compared with platelet-rich plasma injection (standard mean difference: 0.09; 95% confidence interval: -0.66 to 0.84). The risk of bias assessment indicated that all the included trials exhibited a moderate to high risk of bias. Conclusion: Autologous blood injection is more effective than corticosteroid injection but not more effective than platelet-rich plasma injection in treating lateral epicondylosis. However, this evidence is limited by the potential risk of bias. (C) 2015 Elsevier Ltd. All rights reserved.