{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:24:47Z","timestamp":1789496687178,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantify the effect of saline solution injections on patient\u2010reported outcome measures (PROMs) and to determine whether this effect is clinically relevant by comparing it with minimal clinically important difference (MCID) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search identified randomized controlled trials of lateral epicondylitis interventions comparing saline solution injections with nonsurgical injection therapies. Among included studies, saline solution was compared with platelet\u2010rich plasma, autologous conditioned plasma, corticosteroid, and botulinum toxin injections. By use of data from included studies, a random\u2010effects model was used to calculate overall mean differences (MDs) in pre\u2010\u00a0and\u00a0post\u2010injection PROMs in a pair\u2010wise fashion. Calculated MDs were then compared with MCID criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 458 identified studies, 10 met the inclusion criteria and encompassed 283 patients. At 1, 3, 6, and 12\u00a0months, statistically significant improvements in MDs in visual analog scale (VAS) scores were noted as follows: MD of 16.11 (95% confidence interval [CI], 8.29\u201023.93) at 1\u00a0month; MD of 22.50 (95% CI, 11.45\u201033.55) at 3\u00a0months; MD of 40.40 (95% CI, 27.48\u201053.32) at 6\u00a0months; and MD of 47.04 (95% CI, 39.43\u201054.66) at 12\u00a0months. At 6\u00a0months, Disabilities of the Arm, Shoulder and Hand scores showed a statistically significant improvement (MD, 23.92; 95% CI, 9.47\u201038.37).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Improvements in Disabilities of the Arm, Shoulder and Hand scores at 6\u00a0months (23.92) surpassed MCID criteria for conservatively managed upper\u2010extremity musculoskeletal pathology (10.83)\u2014suggesting that saline solution injections have a clinically relevant effect. VAS MCID criteria are poorly established, but VAS scores at 6 and 12\u00a0months surpassed MCID criteria for conservative treatments for common orthopaedic conditions. In all but 1 study, no statistically significant difference in PROMs was found between saline solution and non\u2013saline solution injections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, meta\u2010analysis of Level I and II randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2019.02.051","type":"journal-article","created":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T09:40:09Z","timestamp":1557308409000},"page":"1847","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Therapeutic Benefits of Saline Solution Injection for Lateral Epicondylitis: A Meta\u2010analysis of Randomized Controlled Trials Comparing Saline Injections With Nonsurgical Injection 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