Effects of Hypertonic Dextrose Injection (Prolotherapy) in Lateral Elbow Tendinosis: A Systematic Review and Meta-analysis
Abstract
OBJECTIVE
To systematic review the effectiveness of hypertonic dextrose prolotherapy (DPT) on pain intensity and physical functioning in patients with lateral elbow tendinosis (LET) compared with other active non-surgical treatments.
DATA SOURCES
Systematic search of CENTRAL, MEDLINE, EMBASE, Web of Science, PubMed, Dimensions, Global Health, NHS Health Technology Assessment, AMED and OVID nursing database from inception to 15 June 2021, without language restrictions.
STUDY SELECTION
Two reviewers independently identified parallel or cross-over RCTs that evaluated the effectiveness of DPT in LET. The search identified 245 records; data from 8 studies (354 patients) were included.
DATA EXTRACTION
Two reviewers independently extracted data and assessed included studies. The Cochrane Risk of Bias 2 tool was used to evaluate risk of bias. The Grading of Recommendation Assessment, Development, and Evaluation approach was used to assess quality of the evidence.
DATA SYNTHESIS
Pooled results favored the use of DPT in reducing tennis elbow pain intensity compared with active controls at 12 weeks post-enrollment, with standardized mean difference (SMD) of -0.44 (95% CI -0.88 to -0.01, P =0.04) and of moderate heterogeneity (I2= 49%). Pooled results also favored the use of DPT on physical functioning compared with active controls at 12 weeks, with DASH score achieving mean difference (MD) -15.04 (95% CI -20.25 to -9.82, P < 0.001) and of low heterogeneity (I2= 0.0%). No major related…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 354 participants or records.
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