Table II.
Summary data and analyses
| Outcome or subgroup | No. studies (participants) | Statistical methods | Effect estimate | p-value | Direction of the effect* |
|---|---|---|---|---|---|
| Achillean tendinopathy | |||||
| VISA-A (increase from baseline)-total | 4 (373) | Mean Difference (IV, Random, 95% CI) | −0.17 [−4.25, 3.90] | 0.93 | No difference between groups |
| At 6 wks | 2 (92) | Mean Difference (IV, Random, 95% CI) | −4.46 [−20.59, 11.67] | 0.59 | No difference between groups |
| At 12 wks | 3 (116) | Mean Difference (IV, Random, 95% CI) | −2.23 [−12.04, 7.58] | 0.66 | No difference between groups |
| At 24 wks | 3 (103) | Mean Difference (IV, Random, 95% CI) | −0.70 [−7.66, 6.25] | 0.84 | No difference between groups |
| At 52 wks | 2 (62) | Mean Difference (IV, Random, 95% CI) | 6.34 [−2.42, 15.09] | 0.12 | No difference between groups |
| VISA-A (values over time)-total | 2 (368) | Mean Difference (IV, Random, 95% CI) | 1.74 [−2.40, 5.87] | 0.41 | No difference between groups |
| At 6 wks | 2 (92) | Mean Difference (IV, Random, 95% CI) | 0.48 [−6.92, 7.88] | 0.90 | No difference between groups |
| At 12 wks | 2 (92) | Mean Difference (IV, Random, 95% CI) | 2.98 [−5.86, 11.82] | 0.51 | No difference between groups |
| At 24 wks | 2 (92) | Mean Difference (IV, Random, 95% CI) | 2.88 [−5.08, 10.83] | 0.48 | No difference between groups |
| At 52 wks | 2 (92) | Mean Difference (IV, Random, 95% CI) | 0.79 [−8.51, 10.10] | 0.87 | No difference between groups |
| Patient satisfaction-total | 3 (299) | Risk Difference (M-H, Fixed, 95% CI) | 0.03 [−0.08, 0.13] | 0.64 | No difference between groups |
| At 12 wks | 2 (84) | Risk Difference (M-H, Fixed, 95% CI) | −0.14 [−0.34, 0.06] | 0.17 | No difference between groups |
| At 24–52 wks | 3 (139) | Risk Difference (M-H, Fixed, 95% CI) | 0.02 [−0.13, 0.18] | 0.76 | No difference between groups |
| PRP vs placebo: 12 wks | 1 (38) | Risk Difference (M-H, Fixed, 95% CI) | 0.26 [−0.04, 0.57] | 0.09 | No difference between groups |
| PRP vs placebo: 24 wks | 1 (38) | Risk Difference (M-H, Fixed, 95% CI) | 0.16 [−0.16, 0.47] | 0.32 | No difference between groups |
| Return to sport activity | 4 (174) | Risk Difference (M-H, Fixed, 95% CI) | −0.05 [−0.19, 0.10] | 0.54 | No difference between groups |
| Rotator cuff tendinopathy | |||||
| VAS for pain (values over time)-total | 8 (1046) | Std. Mean Difference (IV, Random, 95% CI) | 0.16 [−0.18, 0.50] | 0.35 | No difference between groups |
| At 1 mo | 7 (324) Std. | Mean Difference (IV, Random, 95% CI) | 0.68 [−0.09, 1.45] | 0.08 | No difference between groups |
| At 3 mos | 7 (290) | Std. Mean Difference (IV, Random, 95% CI) | 0.25 [−0.53, 1.02] | 0.53 | No difference between groups |
| At 6 mos | 7 (312) | Std. Mean Difference (IV, Random, 95% CI) | −0.25 [−0.70, 0.20] | 0.27 | No difference between groups |
| At 12 mos | 2 (120) | Std. Mean Difference (IV, Random, 95% CI) | −0.21 [−0.56, 0.15] | 0.24 | No difference between groups |
| VAS for pain (change from baseline)-total | 1 (281) | Mean Difference (IV, Fixed, 95% CI) | −8.59 [−14.69, −2.49] | 0.006 | Favours PRP |
| At 1 mo | 1 (99) | Mean Difference (IV, Fixed, 95% CI) | −1.90 [−11.76, 7.96] | 0.71 | No difference between groups |
| At 3 mos | 1 (98) | Mean Difference (IV, Fixed, 95% CI) | −14.00 [−24.36, −3.64] | 0.008 | Favours PRP |
| At 12 mos | 1 (94) | Mean Difference (IV, Fixed, 95% CI) | −11.10 [−22.82, 0.62] | 0.06 | No difference between groups |
| Shoulder functional questionnaires (SPADI, DASH, ASES)-total | 8 (966) | Std. Mean Difference (IV, Random, 95% CI) | 0.26 [−0.12, 0.64] | 0.53 | No difference between groups |
| At 1 mo | 7 (299) | Std. Mean Difference (IV, Random, 95% CI) | 0.35 [−0.31, 1.01] | 0.29 | No difference between groups |
| At 3 mos | 7 (315) | Std. Mean Difference (IV, Random, 95% CI) | 0.56 [−0.39, 1.51] | 0.25 | No difference between groups |
| At 6 mos | 7 (312) | Std. Mean Difference (IV, Random, 95% CI) | −0.05 [−0.59, 0.49] | 0.86 | No difference between groups |
| At 12 mos | 1 (40) | Std. Mean Difference (IV, Random, 95% CI) | −0.11 [−0.73, 0.51] | 0.73 | No difference between groups |
| WORC-total | 6 (762) | Std. Mean Difference (IV, Random, 95% CI) | −3.37 [−8.53, 1.79] | 0.20 | No difference between groups |
| At 1 mo | 6 (260) | Mean Difference (IV, Random, 95% CI) | −0.62 [−9.36, 8.13] | 0.89 | No difference between groups |
| At 3 mos | 6 (260) | Mean Difference (IV, Random, 95% CI) | −3.95 [−14.70, 6.80] | 0.47 | No difference between groups |
| At 6 mos | 5 (202) | Mean Difference (IV, Random, 95% CI) | −8.29 [−19.66, 3.08] | 0.15 | No difference between groups |
| At 12 mos | 1 (40) | Mean Difference (IV, Random, 95% CI) | 9.30 [−6.28, 24.88] | 0.24 | No difference between groups |
| Plantar fasciitis | |||||
| VAS for pain (values over time)-total | 6 (626) | Mean Difference (IV, Random, 95% CI) | −3.62 [−8.16, 0.91] | 0.6 | No difference between groups |
| At 3 mos | 5 (214) | Mean Difference (IV, Random, 95% CI) | −3.22 [−10.56, 4.12] | 0.4 | No difference between groups |
| At 6 mos | 6 (254) | Mean Difference (IV, Random, 95% CI) | −3.55 [−10.92, 3.83] | 0.35 | No difference between groups |
| At 12 mos | 3 (158) | Mean Difference (IV, Random, 95% CI) | −5.48 [−16.76, 5.79] | 0.09 | No difference between groups |
| Functional index (AOFAS, FFI)-total | 6 (674) | Mean Difference (IV, Random, 95% CI) | 5.93 [−5.81, 17.67] | 0.32 | No difference between groups |
| At 3 mos | 5 (218) | Mean Difference (IV, Random, 95% CI) | 6.00 [−4.25, 16.25] | 0.25 | No difference between groups |
| At 6 mos | 6 (258) | Mean Difference (IV, Random, 95% CI) | 3.95 [−11.46, 19.36] | 0.62 | No difference between groups |
| At 12 mos | 4 (198) | Mean Difference (IV, Random, 95% CI) | 28.34 [9.08, 47.60] | 0.004 | Favours PRP |
| Lateral epicondilitis | |||||
| VAS for pain (over time)-total | 4 (785) | Mean Difference (IV, Random, 95% CI) | −0.24 [−0.73, 0.25] | 0.34 | No difference between groups |
| At 1 mo | 4 (203) | Mean Difference (IV, Random, 95% CI) | 0.53 [−0.20, 1.26] | 0.15 | No difference between groups |
| At 3 mos | 4 (203) | Mean Difference (IV, Random, 95% CI) | −0.15 [−1.19, 0.88] | 0.77 | No difference between groups |
| At 6 mos | 4 (203) | Mean Difference (IV, Random, 95% CI) | −0.49 [−1.78, 0.81] | 0.46 | No difference between groups |
| At 12 mos | 3 (176) | Mean Difference (IV, Random, 95% CI) | −1.23 [−2.83, 0.37] | 0.13 | No difference between groups |
| Pain change from baseline (VAS, PRTEE)-total | 4 (501) | Std. Mean Difference (IV, Random, 95% CI) | 0.06 [−0.23, 0.35] | 0.69 | No difference between groups |
| At 1 mo | 4 (157) | Std. Mean Difference (IV, Random, 95% CI) | 0.13 [−0.63, 0.89] | 0.74 | No difference between groups |
| At 3 mos | 4 (157) | Std. Mean Difference (IV, Random, 95% CI) | 0.12 [−0.24, 0.47] | 0.52 | No difference between groups |
| At 6 mos | 4 (113) | Std. Mean Difference (IV, Random, 95% CI) | −0.02 [−0.73, 0.69] | 0.96 | No difference between groups |
| At 12 mos | 3 (74) | Std. Mean Difference (IV, Random, 95% CI) | −0.30 [−1.25, 0.65] | 0.53 | No difference between groups |
| Functional measures over time (PRTEE, Liverpool s., MMCPI)-total | 4 (914) | Std. Mean Difference (IV, Random, 95% CI) | −0.05 [−0.34, 0.23] | 0.71 | No difference between groups |
| At 1 mo | 4 (263) | Std. Mean Difference (IV, Random, 95% CI) | −0.22 [−0.47, 0.02] | 0.08 | No difference between groups |
| At 3 mos | 4 (263) | Std. Mean Difference (IV, Random, 95% CI) | −0.21 [−0.62, 0.20] | 0.99 | No difference between groups |
| At 6 mos | 4 (263) | Std. Mean Difference (IV, Random, 95% CI) | 0.04 [−0.69, 0.76] | 0.92 | No difference between groups |
| At 12 mos | 2 (125) | Std. Mean Difference (IV, Random, 95% CI) | 1.11 [−1.80, 4.03] | 0.45 | No difference between groups |
| Functional measures, change from baseline (PRTEE, Liverpool s., MMCPIE)-total | 3 (241) | Std. Mean Difference (IV, Random, 95% CI) | −0.09 [−0.43, 0.25] | 0.61 | No difference between groups |
| At 1 mo | 3 (107) | Std. Mean Difference (IV, Random, 95% CI) | 0.18 [−0.49, 0.86] | 0.60 | No difference between groups |
| At 3 mos | 3 (107) | Std. Mean Difference (IV, Random, 95% CI) | −0.25 [−0.63, 0.13] | 0.20 | No difference between groups |
| At 6 mos | 1 (27) | Std. Mean Difference (IV, Random, 95% CI) | −0.51 [−1.28, 0.26] | 0.19 | No difference between groups |
| Patellar tendinopathy | |||||
| VAS for pain (over time)-total | 3 (212) | Mean Difference (IV, Random, 95% CI) | 0.17 [−0.64, 0.98] | 0.68 | No difference between groups |
| At 1 mo | 1 (38) | Mean Difference (IV, Random, 95% CI) | 0.60 [−0.86, 2.06] | 0.42 | No difference between groups |
| At 3 mos | 2 (61) | Mean Difference (IV, Random, 95% CI) | 0.39 [−0.88, 1.65] | 0.55 | No difference between groups |
| At 6 mos | 3 (81) | Mean Difference (IV, Random, 95% CI) | −0.26 [−2.12, 1.60] | 0.78 | No difference between groups |
| At 12 mos | 1 (32) | Mean Difference (IV, Random, 95% CI) | 0.40 [−1.06, 1.86] | 0.59 | No difference between groups |
| VISA-P (over time)-total | 3 (212) | Mean Difference (IV, Random, 95% CI) | −5.39 [−10.53, −0.25] | 0.04 | Favours control |
| At 1 mo | 1 (38) | Mean Difference (IV, Random, 95% CI) | −6.00 [−19.76, 7.76] | 0.39 | No difference between groups |
| At 3 mos | 2 (61) | Mean Difference (IV, Random, 95% CI) | −4.07 [−13.12, 4.98] | 0.38 | No difference between groups |
| At 6 mos | 3 (81) | Mean Difference (IV, Random, 95% CI) | −3.93 [−17.45, 9.58] | 0.57 | No difference between groups |
| At 12 mos | 1 (32) | Mean Difference (IV, Random, 95% CI) | −9.00 [−22.18, 4.18] | 0.18 | No difference between groups |
| Carpal tunnel syndrome | |||||
| BCTQ-severity score-total | 4 (724) | Mean Difference (IV, Fixed, 95% CI) | −0.24 [−0.32, −0.16] | <0.00001 | Favours PRP |
| At 1 mo | 4 (258) | Mean Difference (IV, Fixed, 95% CI) | −0.17 [−0.30, −0.03] | 0.02 | Favours PRP |
| At 3 mos | 4 (258) | Mean Difference (IV, Fixed, 95% CI) | −0.31 [−0.46, −0.16] | <0.00001 | Favours PRP |
| At 6 mos | 3 (160) | Mean Difference (IV, Fixed, 95% CI) | −0.29 [−0.47, −0.12] | 0.0009 | Favours PRP |
| At 12 mos | 1 (48) | Mean Difference (IV, Fixed, 95% CI) | −0.20 [−0.43, 0.03] | 0.08 | No difference between groups |
| BCTQ-functional score | 4 (724) | Mean Difference (IV, Random, 95% CI) | −0.22 [−0.40, −0.03] | 0.02 | Favours control |
| At 1 mo | 4 (258) | Mean Difference (IV, Random, 95% CI) | 0.00 [−0.23, 0.24] | 0.98 | No difference between groups |
| At 3 mos | 4 (258) | Mean Difference (IV, Random, 95% CI) | −0.43 [−0.85, −0.01] | 0.05 | Favours control |
| At 6 mos | 3 (160) | Mean Difference (IV, Random, 95% CI) | −0.40 [−0.87, 0.08] | 0.10 | No difference between groups |
| At 12 mos | 1 (48) | Mean Difference (IV, Random, 95% CI) | −0.10 [−0.33, 0.13] | 0.39 | No difference between groups |
| VAS for pain (over time)-total | 2 (376) | Mean Difference (IV, Fixed, 95% CI) | −5.29 [−5.67, −4.91] | <0.0001 | Favours PRP |
| At 1 mo | 2 8158) | Mean Difference (IV, Fixed, 95% CI) | 0.01 [−0.73, 0.75] | 0.98 | No difference between groups |
| At 3 mos | 2 (158) | Mean Difference (IV, Fixed, 95% CI) | −3.97 [−4.61, −3.33] | <0.00001 | Favours PRP |
| At 6 mos | 1 (60) | Mean Difference (IV, Fixed, 95% CI) | −10.20 [−10.82, −9.58] | <0.0001 | Favours PRP |
| Adverse events | |||||
| Pain at injection site (% pts) | 7 (359) | Risk Difference (M-H, Random, 95% CI) | 0.10 [0.01, 0.20] | 0.04 | Favours control |
| VAS for pain | 2 (80) | Mean Difference (IV, Fixed, 95% CI) | 2.50 [1.51, 3.49] | <0.0001 | Favours control |
VAS: visual analogue score; DASH: disabilities of the arm, shoulder and hand; PRTEE: patient-rated tennis elbow evaluation; VISA-A: Victorian Institute of Sports Assessments for achillean tendinopathy and for patellar tendinopathy (VISA-P); ASES: American Shoulder and Elbow Surgeons; SPADI: shoulder pain and disability index; BCTQ: Boston Carpal Tunnel Questionnaire, FSS: Functional Status Scale (FSS); SS Severity status Scale; AOFAS: American Orthopedic Foot and Ankle Society Score ; MMCPIE: Mayo Clinic Performance Index for Elbow; FFI: foot function index; WORC: West Ontario rotator cuff index; Std.: standardized; IV: inverse variance method; M-H: Mantel-Haenszel method; Fixed: fixed effect model; random: random effect model.