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Extracorporeal Shock Wave Therapy Shows Superiority Over Injections for Pain Relief and Grip Strength Recovery in Lateral Epicondylitis: A Systematic Review and Network Meta-analysis

  • Wen-Chih Liu
    Affiliations
    Department of Orthopedic Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan

    Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Ph.D Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Chih-Ting Chen
    Affiliations
    School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Cheng-Chang Lu
    Affiliations
    Department of Orthopedic Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan

    Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Yun-Che Tsai
    Affiliations
    Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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  • Ying-Chun Liu
    Affiliations
    School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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  • Chih-Wei Hsu
    Affiliations
    Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
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  • Chia-Lung Shih
    Affiliations
    Department of Medical Research, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
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  • Po-Cheng Chen
    Correspondence
    Address correspondence to Po-Cheng Chen, M.D., M.P.H., Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong District, Kaohsiung, 833, Taiwan.
    Affiliations
    Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan

    Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yin-Chih Fu
    Affiliations
    Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Ph.D Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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Published:January 27, 2022DOI:https://doi.org/10.1016/j.arthro.2022.01.025

      Purpose

      To examine the efficacy of extracorporeal shock wave therapy (ESWT) and injection therapies by synthesizing direct and indirect evidence for all pairs of competing therapies for lateral epicondylitis.

      Methods

      PubMed, EMBASE, and Web of Science databases were searched for all appropriate randomized controlled trials (RCTs), assessing the effect of ESWT or injection therapies. The primary outcome was short-term (≤3 months) and medium-term (>3 months but ≤12 months) pain, while the secondary outcomes were grip strength and patient-reported outcome measures. All outcomes were assessed using standardized mean differences (SMDs) with 95% confidence intervals (CIs) and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments. Sensitivity analysis was performed to eliminate potential therapeutic effects of normal saline (NS) and exclude trials that included patients with acute lateral epicondylitis (LE).

      Results

      40 RCTs were included to evaluate ESWT and five different injection therapies, including corticosteroids (CSs), autologous whole blood, platelet-rich plasma (PRP), botulinum toxin A (BoNT-A), and dextrose prolotherapy (DPT). DPT (−.78 [−1.34 to −.21]), ESWT (.57 [−.89 to −.25]), PRP (−.48 [−.85 to −.11]), and BoNT-A (−.43 [−.84 to −.02]) outperformed placebo for short-term pain relief; ESWT (−.44 [−.85 to −.04]) outperformed placebo for medium-term pain relief. DPT was ranked as the most optimal short-term and medium-term pain reliever (SUCRA, 87.3% and 98.6%, respectively). ESWT was ranked as the most optimal short-term and medium-term grip strength recovery (SUCRA; 79.4% and 86.4%, respectively).

      Conclusions

      DPT and ESWT were the best two treatment options for pain control and ESWT was the best treatment option for grip strength recovery. CSs were not recommended for the treatment of LE. More evidence is required to confirm the superiority in pain control of DPT among all these treatment options on LE.

      Level of Evidence

      Level I, meta-analysis of Level I randomized controlled trials.

      Key Words

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      References

        • Sims S.E.
        • Miller K.
        • Elfar J.C.
        • Hammert W.C.
        Non-surgical treatment of lateral epicondylitis: A systematic review of randomized controlled trials.
        Hand (N Y). 2014; 9: 419-446
        • Vaquero-Picado A.
        • Barco R.
        • Antuna S.A.
        Lateral epicondylitis of the elbow.
        EFORT Open Rev. 2016; 1: 391-397
        • Sanders Jr., T.L.
        • Maradit Kremers H.
        • Bryan A.J.
        • Ransom J.E.
        • Smith J.
        • Morrey B.F.
        The epidemiology and health care burden of tennis elbow: A population-based study.
        Am J Sports Med. 2015; 43: 1066-1071
        • Calfee R.P.
        • Patel A.
        • DaSilva M.F.
        • Akelman E.
        Management of lateral epicondylitis: current concepts.
        J Am Acad Orthop Surg. 2008; 16: 19-29
        • Lai W.C.
        • Erickson B.J.
        • Mlynarek R.A.
        • Wang D.
        Chronic lateral epicondylitis: Challenges and solutions.
        Open Access J Sports Med. 2018; 9: 243-251
        • Tang H.Y.
        • Yu T.
        • Wei W.
        • Zhao Y.
        Effect of extracorporeal shock wave for tennis elbow: A protocol for systematic review of randomized controlled trial.
        Medicine (Baltimore). 2019; 98e14517
        • Martin S.D.
        • Conaway W.K.
        • Lei P.
        Use of intra-articular corticosteroids in orthopaedics.
        J Bone Joint Surg Am. 2018; 100: 885-891
        • Ahmad Z.
        • Siddiqui N.
        • Malik S.S.
        • Abdus-Samee M.
        • Tytherleigh-Strong G.
        • Rushton N.
        Lateral epicondylitis: A review of pathology and management.
        Bone Joint J. 2013; 95-B: 1158-1164
        • Creuzé A.
        • Petit H.
        • de Seze M.
        Short-term effect of low-dose, electromyography-guided botulinum toxin A injection in the treatment of chronic lateral epicondylar tendinopathy: A randomized, double-blinded study.
        J Bone Joint Surg Am. 2018; 100: 818-826
        • Chou L.C.
        • Liou T.H.
        • Kuan Y.C.
        • Huang Y.H.
        • Chen H.C.
        Autologous blood injection for treatment of lateral epicondylosis: a meta-analysis of randomized controlled trials.
        Phys Ther Sport. 2016; 18: 68-73
        • Reeves K.D.
        • Sit R.W.
        • Rabago D.P.
        Dextrose prolotherapy: A narrative review of basic science, clinical research, and best treatment recommendations.
        Phys Med Rehabil Clin N Am. 2016; 27: 783-823
        • Kim Y.J.
        • Wood S.M.
        • Yoon A.P.
        • Howard J.C.
        • Yang L.Y.
        • Chung K.C.
        Efficacy of nonoperative treatments for lateral epicondylitis: a systematic review and meta-analysis.
        Plast Reconstr Surg. 2021; 147: 112-125
        • Hutton B.
        • Salanti G.
        • Caldwell D.M.
        • et al.
        The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: Checklist and explanations.
        Ann Intern Med. 2015; 162: 777-784
        • Higgins J.P.
        • Altman D.G.
        • Gøtzsche P.C.
        • et al.
        The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.
        BMJ. 2011; 343: d5928
        • Chaimani A.
        • Higgins J.P.
        • Mavridis D.
        • Spyridonos P.
        • Salanti G.
        Graphical tools for network meta-analysis in STATA.
        PLoS One. 2013; 8e76654
        • Lin L.
        • Xing A.
        • Kofler M.J.
        • Murad M.H.
        Borrowing of strength from indirect evidence in 40 network meta-analyses.
        J Clin Epidemiol. 2019; 106: 41-49
        • Chaimani A.
        • Salanti G.
        Visualizing assumptions and results in network meta-analysis: The network graphs package.
        Stata J. 2015; 15: 905-995
        • Cipriani A.
        • Higgins J.P.
        • Geddes J.R.
        • Salanti G.
        Conceptual and technical challenges in network meta-analysis.
        Ann Intern Med. 2013; 159: 130-137
        • Jansen J.P.
        • Naci H.
        Is network meta-analysis as valid as standard pairwise meta-analysis? It all depends on the distribution of effect modifiers.
        BMC Med. 2013; 11: 159
        • Salanti G.
        Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: Many names, many benefits, many concerns for the next generation evidence synthesis tool.
        Res Synth Methods. 2012; 3: 80-97
        • Normand S.L.
        Meta-analysis: Formulating, evaluating, combining, and reporting.
        Stat Med. 1999; 18: 321-359
        • Shim S.
        • Yoon B.H.
        • Shin I.S.
        • Bae J.M.
        Network meta-analysis: application and practice using Stata.
        Epidemiol Health. 2017; 39e2017047
        • Salanti G.
        • Ades A.E.
        • Ioannidis J.P.
        Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial.
        J Clin Epidemiol. 2011; 64: 163-171
        • Higgins J.P.
        • Jackson D.
        • Barrett J.K.
        • Lu G.
        • Ades A.E.
        • White I.R.
        Consistency and inconsistency in network meta-analysis: concepts and models for multi-arm studies.
        Res Synth Methods. 2012; 3 (98-11)
        • Dias S.
        • Welton N.J.
        • Caldwell D.M.
        • Ades A.E.
        Checking consistency in mixed treatment comparison meta-analysis.
        Stat Med. 2010; 29: 932-944
        • Akcay S.
        • Kandemir N.G.
        • Kaya T.
        • Dogan N.
        • Eren M.
        Dextrose prolotherapy versus normal saline injection for the treatment of lateral epicondylopathy: A randomized controlled trial.
        J Altern Complement Med. 2020; 26: 1159-1168
        • Beyazal M.S.
        • Devrimsel G.
        Comparison of the effectiveness of local corticosteroid injection and extracorporeal shock wave therapy in patients with lateral epicondylitis.
        J Phys Ther Sci. 2015; 27: 3755-3758
        • Bisset L.
        • Beller E.
        • Jull G.
        • Brooks P.
        • Darnell R.
        • Vicenzino B.
        Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: Randomised trial.
        BMJ. 2006; 333: 939
        • Capan N.
        • Esmaeilzadeh S.
        • Oral A.
        • Basoglu C.
        • Karan A.
        • Sindel D.
        Radial extracorporeal shock wave therapy is not more effective than placebo in the management of lateral epicondylitis: A double-blind, randomized, placebo-controlled trial.
        Am J Phys Med Rehabil. 2016; 95: 495-506
        • Carayannopoulos A.
        • Borg-Stein J.
        • Sokolof J.
        • Meleger A.
        • Rosenberg D.
        Prolotherapy versus corticosteroid injections for the treatment of lateral epicondylosis: A randomized controlled trial.
        PM R. 2011; 3: 706-715
        • Chung B.
        • Wiley J.P.
        Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: A randomized controlled trial.
        Am J Sports Med. 2004; 32: 1660-1667
        • Coombes B.K.
        • Bisset L.
        • Brooks P.
        • Khan A.
        • Vicenzino B.
        Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: A randomized controlled trial.
        JAMA. 2013; 309: 461-469
        • Creaney L.
        • Wallace A.
        • Curtis M.
        • Connell D.
        Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: A prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections.
        Br J Sports Med. 2011; 45: 966-971
        • Dogramaci Y.
        • Kalaci A.
        • Savas N.
        • Duman I.G.
        • Yanat A.N.
        Treatment of lateral epicondilitis using three different local injection modalities: A randomized prospective clinical trial.
        Arch Orthop Trauma Surg. 2009; 129: 1409-1414
        • Dojode C.M.
        A randomised control trial to evaluate the efficacy of autologous blood injection versus local corticosteroid injection for treatment of lateral epicondylitis.
        Bone Joint Res. 2012; 1: 192-197
        • Espandar R.
        • Heidari P.
        • Rasouli M.R.
        • et al.
        Use of anatomic measurement to guide injection of botulinum toxin for the management of chronic lateral epicondylitis: A randomized controlled trial.
        Can Med Assoc J. 2010; 182: 768-773
        • Guo Y.H.
        • Kuan T.S.
        • Chen K.L.
        • et al.
        Comparison between steroid and 2 different sites of botulinum toxin injection in the treatment of lateral epicondylalgia: A randomized, double-blind, active drug-controlled pilot study.
        Arch Phys Med Rehabil. 2017; 98: 36-42
        • Hsieh L.F.
        • Kuo Y.C.
        • Lee C.C.
        • Liu Y.F.
        • Liu Y.C.
        • Huang V.
        Comparison between corticosteroid and lidocaine injection in the treatment of tennis elbow: A randomized, double-blinded, controlled trial article.
        Am J Phys Med Rehabil. 2018; 97: 83-89
        • Kazemi M.
        • Azma K.
        • Tavana B.
        • Rezaiee Moghaddam F.
        • Panahi A.
        Autologous blood versus corticosteroid local injection in the short-term treatment of lateral elbow tendinopathy: A randomized clinical trial of efficacy.
        Am J Phys Med Rehabil. 2010; 89: 660-667
        • Krogh T.P.
        • Bartels E.M.
        • Ellingsen T.
        • et al.
        Comparative effectiveness of injection therapies in lateral epicondylitis: A systematic review and network meta-analysis of randomized controlled trials.
        Am J Sports Med. 2013; 41: 1435-1446
        • Lin Y.C.
        • Tu Y.K.
        • Chen S.S.
        • Lin I.L.
        • Chen S.C.
        • Guo H.R.
        Comparison between botulinum toxin and corticosteroid injection in the treatment of acute and subacute tennis elbow: A prospective, randomized, double-blind, active drug-controlled pilot study.
        Am J Phys Med Rehabil. 2010; 89: 653-659
        • Lindenhovius A.
        • Henket M.
        • Gilligan B.P.
        • Lozano-Calderon S.
        • Jupiter J.B.
        • Ring D.
        Injection of dexamethasone versus placebo for lateral elbow pain: A prospective, double-blind, randomized clinical trial.
        J Hand Surg Am. 2008; 33: 909-919
        • Linnanmäki L.
        • Kanto K.
        • Karjalainen T.
        • Leppänen O.V.
        • Lehtinen J.
        Platelet-rich plasma or autologous blood do not reduce pain or improve function in patients with lateral epicondylitis: A randomized controlled trial.
        Clin Orthop Relat Res. 2020; 478: 1892-1900
        • Montalvan B.
        • Le Goux P.
        • Klouche S.
        • Borgel D.
        • Hardy P.
        • Breban M.
        Inefficacy of ultrasound-guided local injections of autologous conditioned plasma for recent epicondylitis: Results of a double-blind placebo-controlled randomized clinical trial with one-year follow-up.
        Rheumatology (Oxford). 2016; 55: 279-285
        • Olaussen M.
        • Holmedal O.
        • Mdala I.
        • Brage S.
        • Lindbaek M.
        Corticosteroid or placebo injection combined with deep transverse friction massage, Mills manipulation, stretching and eccentric exercise for acute lateral epicondylitis: A randomised, controlled trial.
        BMC Musculoskelet Disord. 2015; 16: 122
        • Ozturan K.E.
        • Yucel I.
        • Cakici H.
        • Guven M.
        • Sungur I.
        Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis.
        Orthopedics. 2010; 33: 84-91
        • Peerbooms J.C.
        • Sluimer J.
        • Bruijn D.J.
        • Gosens T.
        Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: Platelet-rich plasma versus corticosteroid injection with a 1-year follow-up.
        Am J Sports Med. 2010; 38: 255-262
        • Pettrone F.A.
        • McCall B.R.
        Extracorporeal shock wave therapy without local anesthesia for chronic lateral epicondylitis.
        J Bone Joint Surg Am. 2005; 87: 1297-1304
        • Placzek R.
        • Drescher W.
        • Deuretzbacher G.
        • Hempfing A.
        • Meiss A.L.
        Treatment of chronic radial epicondylitis with botulinum toxin A. A double-blind, placebo-controlled, randomized multicenter study.
        J Bone Joint Surg Am. 2007; 89: 255-260
        • Rabago D.
        • Lee K.S.
        • Ryan M.
        • et al.
        Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): Results of a single-blind, pilot-level, randomized controlled trial.
        Am J Phys Med Rehabil. 2013; 92: 587-596
        • Raeissadat S.A.
        • Sedighipour L.
        • Rayegani S.M.
        • Bahrami M.H.
        • Bayat M.
        • Rahimi R.
        Effect of platelet-rich plasma (PRP) versus autologous whole blood on pain and function improvement in tennis elbow: A randomized clinical trial.
        Pain Res Treat. 2014; 2014: 191525
        • Rompe J.D.
        • Decking J.
        • Schoellner C.
        • Theis C.
        Repetitive low-energy shock wave treatment for chronic lateral epicondylitis in tennis players.
        Am J Sports Med. 2004; 32: 734-743
        • Spacca G.
        • Necozione S.
        • Cacchio A.
        Radial shock wave therapy for lateral epicondylitis: A prospective randomised controlled single-blind study.
        Eura Medicophys. 2005; 41: 17-25
        • Scarpone M.
        • Rabago D.P.
        • Zgierska A.
        • Arbogast G.
        • Snell E.
        The efficacy of prolotherapy for lateral epicondylosis: a pilot study.
        Clin J Sport Med. 2008; 18: 248-254
        • Schöffl V.
        • Willauschus W.
        • Sauer F.
        • et al.
        Autologous conditioned plasma versus placebo injection therapy in lateral epicondylitis of the elbow: A double blind, randomized study.
        Sportverletz Sportschaden. 2017; 31: 31-36
        • Speed C.A.
        • Nichols D.
        • Richards C.
        • et al.
        Extracorporeal shock wave therapy for lateral epicondylitis—a double blind randomized controlled trial.
        J Orthop Res. 2002; 20 (Pii s0736-0266(02)00013-x): 895-898
        • Staples M.P.
        • Forbes A.
        • Ptasznik R.
        • Gordon J.
        • Buchbinder R.
        A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (tennis elbow).
        J Rheumatol. 2008; 35: 2038-2046
        • Stenhouse G.
        • Sookur P.
        • Watson M.
        Do blood growth factors offer additional benefit in refractory lateral epicondylitis? A prospective, randomized pilot trial of dry needling as a stand-alone procedure versus dry needling and autologous conditioned plasma.
        Skeletal Radiol. 2013; 42: 1515-1552
        • Thanasas C.
        • Papadimitriou G.
        • Charalambidis C.
        • Paraskevopoulos I.
        • Papanikolaou A.
        Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis. A randomized controlled clinical trial.
        Am J Sports Med. 2011; 39: 2130-2134
        • Tonks J.H.
        • Pai S.K.
        • Murali S.R.
        Steroid injection therapy is the best conservative treatment for lateral epicondylitis: A prospective randomised controlled trial.
        Int J Clin Pract. 2007; 61: 240-246
        • Wolf J.M.
        • Ozer K.
        • Scott F.
        • Gordon M.J.V.
        • Williams A.E.
        Comparison of autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: A prospective, randomized, controlled multicenter study.
        J Hand Surg Am. 2011; 36: 1269-1272
        • Wong S.M.
        • Hui A.C.F.
        • Tong P.Y.
        • Poon D.W.F.
        • Yu E.
        • Wong L.K.S.
        Treatment of lateral epicondylitis with botulinum toxin. A randomized, double-blind, placebo-controlled trial.
        Ann Intern Med. 2005; 143: 793-797
        • Yang T.H.
        • Huang Y.C.
        • Lau Y.C.
        • Wang L.Y.
        Efficacy of radial extracorporeal shock wave therapy on lateral epicondylosis, and changes in the common extensor tendon stiffness with pretherapy and posttherapy in real-time sonoelastography: A randomized controlled study.
        Am J Phys Med Rehabil. 2017; 96 (93-10)
        • Yerlikaya M.
        • Talay Calis H.
        • Tomruk Sutbeyaz S.
        • et al.
        Comparison of effects of leukocyte-rich and leukocyte-poor platelet-rich plasma on pain and functionality in patients with lateral epicondylitis.
        Arch Rheumatol. 2018; 33: 73-79
        • Crowther M.A.
        • Bannister G.C.
        • Huma H.
        • Rooker G.D.
        A prospective, randomised study to compare extracorporeal shock-wave therapy and injection of steroid for the treatment of tennis elbow.
        J Bone Joint Surg Br. 2002; 84: 678-679
        • Guler N.S.
        • Sargin S.
        • Sahin N.
        Efficacy of extracorporeal shockwave therapy in patients with lateral epicondylitis: A randomized, placebo-controlled, double-blind clinical trial.
        North Clin Istanb. 2018; 5: 314-318
        • Hay E.M.
        • Paterson S.M.
        • Lewis M.
        • Hosie G.
        • Croft P.
        Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care.
        BMJ. 1999; 319: 964-968
        • Newcomer K.L.
        • Laskowski E.R.
        • Idank D.M.
        • McLean T.J.
        • Egan K.S.
        Corticosteroid injection in early treatment of lateral epicondylitis.
        Clin J Sport Med. 2001; 11: 214-222
        • Seetharamaiah V.B.
        • Gantaguru A.
        • Basavarajanna S.
        A comparative study to evaluate the efficacy of platelet-rich plasma and triamcinolone to treat tennis elbow.
        Indian J Orthop. 2017; 51: 304-311
        • Tahririan M.A.
        • Moayednia A.
        • Momeni A.
        • Yousefi A.
        • Vahdatpour B.
        A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis.
        J Res Med Sci. 2014; 19: 813-818
        • Mishra A.K.
        • Skrepnik N.V.
        • Edwards S.G.
        • et al.
        Efficacy of platelet-rich plasma for chronic tennis elbow: A double-blind, prospective, multicenter, randomized controlled trial of 230 patients.
        Am J Sports Med. 2014; 42: 463-471
        • Gündüz R.
        • Malas F.U.
        • Borman P.
        • Kocaoğlu S.
        • Özçakar L.
        Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison.
        Clin Rheumatol. 2012; 31: 807-812
        • Haake M.
        • Konig I.R.
        • Decker T.
        • et al.
        Extracorporeal shock wave therapy in the treatment of lateral epicondylitis: A randomized multicenter trial.
        J Bone Joint Surg Am. 2002; 84: 1982-1991
        • Gosens T.
        • Peerbooms J.C.
        • van Laar W.
        • den Oudsten B.L.
        Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year follow-up.
        Am J Sports Med. 2011; 39: 1200-1208
        • Collins E.
        • Hildreth D.
        • Jafarnia K.
        A clinical study of extracorporeal shock waves (ESW) for treatment of chronic lateral epicondylitis.
        Curr Orthop Pract. 2011; 22: 185-192
        • Keijsers R.
        • Kuijer P.
        • Koenraadt K.L.M.
        • et al.
        Effectiveness of standardized ultrasound guided percutaneous treatment of lateral epicondylitis with application of autologous blood, dextrose or perforation only on pain: a study protocol for a multi-center, blinded, randomized controlled trial with a 1year follow up.
        BMC Musculoskelet Disord. 2019; 20: 351
        • Lewis M.
        • Hay E.M.
        • Paterson S.M.
        • Croft P.
        Local steroid injections for tennis elbow: Does the pain get worse before it gets better? Results from a randomized controlled trial.
        Clin J Pain. 2005; 21: 330-334
        • Hayton M.J.
        • Santini A.J.A.
        • Hughes P.J.
        • Frostick S.P.
        • Trail I.A.
        • Stanley J.K.
        Botulinum toxin injection in the treatment of tennis elbow. A double-blind, randomized, controlled, pilot study.
        J Bone Joint Surg Am. 2005; 87A: 503-507
        • Acosta-Olivo C.A.
        • Millan-Alanis J.M.
        • Simental-Mendia L.E.
        • et al.
        Effect of normal saline injections on lateral epicondylitis symptoms: A systematic review and meta-analysis of randomized clinical trials.
        Am J Sports Med. 2020; 48: 3094-3102
        • Gao B.
        • Dwivedi S.
        • DeFroda S.
        • et al.
        The therapeutic benefits of saline solution injection for lateral epicondylitis: A meta-analysis of randomized controlled trials comparing saline injections with nonsurgical injection therapies.
        Arthroscopy. 2019; 35: 1847-1859
        • Navarro-Santana M.J.
        • Sanchez-Infante J.
        • Gomez-Chiguano G.F.
        • et al.
        Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: A systematic review and meta-analysis.
        Clin Rehabil. 2020; 34: 1327-1334
        • Schmitz C.
        • Csaszar N.B.
        • Milz S.
        • et al.
        Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: A systematic review on studies listed in the PEDro database.
        Br Med Bull. 2015; 116: 115-138
        • Buchbinder R.
        • Green S.E.
        • Youd J.M.
        • Assendelft W.J.
        • Barnsley L.
        • Smidt N.
        Shock wave therapy for lateral elbow pain.
        Cochrane Database Syst Rev. 2005; 4: CD003524
        • Zheng C.X.
        • Zeng D.J.
        • Chen J.Y.
        • et al.
        Effectiveness of extracorporeal shock wave therapy in patients with tennis elbow: A meta-analysis of randomized controlled trials.
        Medicine (Baltimore). 2020; 99: 21189
        • Xiong Y.
        • Xue H.
        • Zhou W.
        • et al.
        Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: A meta-analysis of randomized controlled trials.
        Phys Sportsmed. 2019; 47: 284-289
        • Speed C.A.
        Fortnightly review: Corticosteroid injections in tendon lesions.
        BMJ. 2001; 323: 382-386
        • Dong W.
        • Goost H.
        • Lin X.B.
        • et al.
        Injection therapies for lateral epicondylalgia: A systematic review and Bayesian network meta-analysis.
        Br J Sports Med. 2016; 50: 900-908