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Table 1 Details of studies comparing autologous blood and corticosteroid injections

From: The effects of regenerative injection therapy compared to corticosteroids for the treatment of lateral Epicondylitis: a systematic review and meta-analysis

Reference/ PEDro score
Sackett’s Evidence Level
ParticipantsMethodsOutcome MeasuresResults
Kazemi et al. (2010),
PEDro = 6,
n = 60 participants; AB group: 30;
Age: 47.2 ± 10.6 yrs.
7 males, 23 females
CS group: 30
Age: 47.0 ± 10.3 yrs.
4 males, 26 females
• Participants received one injection into the lateral epicondyle region just inferior to the ECRB.
• Two ml of AB mixed with one ml of 2% lidocaine injected in the AB group, while 20 mg methylprednisolone with one ml of 2% lidocaine provided in CS group.
• Outcomes assessed before and after injection (four- and 8-weeks post-injection).
• VAS
• Pain and strength in maximum grip
• Quick DASH scores
• Modified Nirschl scores
• Pressure pain threshold
• Limb pain at rest, Quick DASH scores and pain in maximum grip lower in AB group at 4 weeks. (p < 0.01)
• All the outcome measures significantly better in the AB group at 8 weeks evaluation (p < 0.001).
Dojode 2012
PEDro = 6
n = 60 participants
AB group: 30
Mean Age: 42.9 yrs.
13 males, 17 females
CS group: 30
Mean Age: 42.2 yrs.
12 males, 18 females
• All participants received injections at the lateral epicondyle into the undersurface of the ECRB.
• AB: two ml drawn from the contralateral upper limb vein mixed with one ml 0.5% bupivacaine.
• CS: two ml of methyl prednisolone acetate (80 mg) mixed with one ml 0.5% bupivacaine, at the lateral epicondyle.
• Outcomes assessed pre-injection and at one, 4, 12 weeks and 6 months following the injection.
• VAS,
• Nirschl staging of lateral epicondylitis
• CS group showed statistically significant decrease in pain compared to AB group in both outcomes at one and 4 weeks.
• At 12 weeks, the VAS and Nirschl scores were significantly lower in the AB group (p = 0.0127 and p = 0.0184, respectively); this was maintained at 6 months
• At final retention assessment, 47% in CS group and 90% in AB group were completely relieved of pain.
Arik et al. (2014)
PEDro = 5
n = 80 participants
AB group: 40;
Age: 43.7 ± 7.8 yrs.
11 males, 29 females
CS group: 40
Age: 46.7 ± 8.4 yrs.
10 males, 30 females
• Participants were given a single injection of AB (two ml venous blood collected from antecubital fossa of ipsilateral side mixed with one ml of 2% prilocaine hydrochloride) or CS injections (one ml of 40 mg methylprednisolone acetate mixed with one ml of 2% prilocaine hydrochloride).
• Each participant was assessed before treatment and at day 15, 30, and 90 after the injection.
• VAS
• PRTEE questionnaire
• Grip strength (using a hydraulic hand dynamometer)
• CS injection improved all outcomes at a faster rate over the first 15 days (p = 0.0001), and then started to decline slightly until day 90.
• After AB injection, all three scores improved steadily and were eventually better (p = 0.0001).
• 38 (95%) of participants with AB injection and 25 (62.5%) of participants with CS injection achieved complete recovery.
Lebiedzinskieet al. (2015)
PEDro = 6,
n = 99 participants;
ACP group: 53
Mean Age: 47.0 yrs.
28 males, 25 females
CS: 46
Mean Age: 54.0 yrs.
12 males, 34 females
• Participants received one injection in the ECRB of ACP or CS (one ml betamethasone injections and two ml of 1% lignocaine)
• Baseline evaluation of DASH and re-evaluation at 6 weeks, 6 months, and 1 year.
• DASH: 15-point increase set as significant change• The steroid group had better mean DASH scores at 6 weeks (p = .01) and tended to have lower scores at 6 months (p = .05).
• At 1 year, the mean DASH score was significantly better in the ACP group (p < .05).
Wolf et al. (2011),
PEDro = 6
n = 28 participants; Saline group: 10
AB group: 9
CS group: 9
Overall average age: 49 yrs.
16 males, 12 females
• Participants received each injection with one mL lidocaine mixed with two mL of designated injection placed under the extensor origin.
• Every provided with a standard sheet of stretching exercises.
• Outcomes assessed at baseline, and at 2 weeks, 2 months and 6 months after injection.
• DASH
• VAS
• PRTEE
• No significant between group differences in DASH scores were found at the two- and 6-months assessments.
• There were significant improvements in all three groups (p < 0.001) over the course of 6 months for the DASH.
  1. PEDro Physiotherapy Evidence Database Research Organisation, AB Autologous blood, CS Corticosteroid, ECRB Extensor Carpi Radialis Brevis, VAS Visual Analog Scale, DASH Disabilities of the Arm, Shoulder and Hand, PRTEE Patient Rated Tennis Elbow Evaluation, qDASH Quick form of DASH