Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

Table 4 Comparisons of treatment effects: a network meta-analysis

From: Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean	95 % CI	P value	N	Mean	95 % CI	P value
VAS
PRP	153	3.64	2.84, 4.45	<0.001*	168	2.27	1.51, 3.02	<0.001*
AB	132	2.99	2.19, 3.80	<0.001*	132	2.90	2.09, 3.70	<0.001*
Steroid	79	4.18	3.04, 5.33,	<0.001*	94	4.29	3.31, 5.27	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean difference	95 % CI	P value	N	Mean difference	95 % CI	P value
VAS
PRP vs. steroid	–	−0.54	−1.76, 0.68	0.386	–	−2.02	−3.04, −1.01	<0.001*
AB vs. steroid	–	−1.19	−2.41, 0.03	0.056	–	−1.39	−2.48, −0.30	0.012*
PRP vs. AB	–	0.65	−0.21, 1.51	0.138	–	−0.63	−1.47, 0.20	0.138

Treatment	Within 2 months				At last follow-up
	N	Mean	95 % CI	P value	N	Mean	95 % CI	P value
DASH
PRP	51	46.15	35.37, 56.93	<0.001*	66	17.38	8.42, 26.33	<0.001*
AB	30	7.49	−7.61, 22.59	<0.001*	30	7.49	−7.61, 22.59	<0.001*
Steroid	79	31.76	22.81, 40.71	<0.001*	94	35.95	28.10, 43.80	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean difference	95 % CI	P value	N	Mean difference	95 % CI	P value
DASH
PRP vs. steroid	–	14.39	1.77, 27.00	0.025*	–	−18.58	−29.08, −8.08	0.001*
AB vs. steroid	–	−24.27	−40.68, −7.86	0.004*	–	−24.27	−40.68, −7.86	0.004*
PRP vs. AB	–	38.66	20.48, 56.83	<0.001*	–	9.88	−7.32, 27.08	0.260

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean	95 % CI	P value	N	Mean	95 % CI	P value
PRTEE
PRP	100	36.37	24.09, 48.66	<0.001*	100	29.31	17.03, 41.60	<0.001*
AB	100	34.12	21.84, 46.41	<0.001*	100	33.87	21.59, 46.16	<0.001*
Steroid	50	30.82	18.53, 43.11	<0.001*	50	32.53	20.24, 44.82	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean difference	95 % CI	P value	N	Mean difference	95 % CI	P value
PRTEE
PRP vs. steroid	–	5.55	−6.65, 17.76	0.373	–	−3.22	−15.42, 8.99	0.605
AB vs. steroid	–	3.30	−8.90, 15.51	0.596	–	1.34	−10.86, 13.55	0.829
PRP vs. AB	–	2.25	−9.96, 14.46	0.718	–	−4.56	−16.77, 7.65	0.464

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean	95 % CI	P value	N	Mean	95 % CI	P value
PPT
PRP	58	18.58	12.66, 24.51	<0.001*	58	20.03	14.11, 25.96	<0.001*
AB	30	21.23	15.16, 27.31	<0.001*	30	27.53	21.46, 33.61	<0.001*
Steroid	88	17.57	11.70, 23.44	<0.001*	88	17.67	11.80, 23.54	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	Mean difference	95 % CI	P value	N	Mean difference	95 % CI	P value
PPT
PRP vs. steroid	–	1.02	−0.48, 2.52	0.184	–	2.37	0.87, 3.87	0.02*
AB vs. steroid	–	3.67	1.64, 5.69	<0.001*	–	9.87	7.84, 11.89	<0.001*
PRP vs. AB	–	−2.65	−5.00, −0.30	<0.001	–	−7.50	−9.85, −5.15	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	IR	95 % CI	P value	N	IR	95 % CI	P value
Adverse effects
PRP	–	–	–	–	85	0.10	0.03, 0.34	<0.001*
AB	–	–	–	–	74	0.20	0.06, 0.65	0.008*
Steroid	–	–	–	–	129	0.11	0.03, 0.35	<0.001*

Treatment	Within 2 months				At last follow-up
Treatment	N	RR	95 % CI	P value	N	RR	95 % CI	P value
Adverse effects
PRP vs. steroid	–	–	–	–	–	0.90	0.36, 2.24	0.821
AB vs. steroid	–	–	–	–	–	1.88	0.95, 3.72	0.068
PRP vs. AB	–	–	–	–	–	0.004	0.0002, 0.09	0.001*

PRP platelet-rich plasma, AB autologous blood, Steroid corticosteroid, VAS visual analog score, DASH Disabilities of the Arm Shoulder and Hand, PRTEE Patient-Rated Tennis Elbow Evaluation, PPT pressure pain threshold, CI confidence interval, IR incident rate, RR relative risk
* Statistically significant difference (P < 0.05)

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