{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:28:41Z","timestamp":1792664921360,"version":"4.5.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) evaluating the efficacy of platelet-rich plasma (PRP) for the management of lateral epicondylitis (LE) have been characterized by substantial variability in reported outcomes. The source of this heterogeneity is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine the effect of estimated platelet concentration on the efficacy of PRP for the management of LE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All RCTs evaluating the efficacy of PRP in managing LE were identified. RCTs were classified according to whether the study documented a platelet concentration factor of PRP representing a greater than 3-fold increase over whole blood or a supraphysiological platelet dose (high-dose vs low-dose PRP). The primary outcome was the mean difference (MD) in the visual analog scale (VAS) score at latest follow-up. Random-effects and mixed-effects meta-analyses were performed, and meta-regression was used to evaluate whether differences in outcomes after treatment with PRP could be explained by differences in the concentration of PRP used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 13 RCTs with a total of 791 patients were included in this analysis, with 5 that utilized low-dose PRP and 8 that used high-dose PRP. Meta-analysis of VAS scores reported by studies that used high-dose PRP resulted in an MD of \u22121.31 (95% CI, \u22121.87 to \u22120.75) in favor of PRP over all alternative treatment strategies (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Meta-analysis of VAS scores reported by studies that used low-dose PRP resulted in an MD of 0.08 (95% CI, \u22120.51 to 0.68), suggesting no difference in the effect between PRP and all alternative treatment strategies (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .79). The platelet concentration factor of PRP used in each RCT was found to be strongly predictive of the VAS score at final follow-up in meta-regression (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), with 58.5% of the heterogeneity in the outcomes of PRP between studies explained by the platelet concentration factor alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The platelet concentration of PRP may play a significant role in the outcomes of patients with LE. A direct linear relationship was observed between the platelet concentration factor of PRP used and the magnitude of patient-reported symptom relief after the management of LE with PRP. Clinicians should ensure a supraphysiological platelet concentration when preparing PRP for the management of LE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241303716","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T13:26:14Z","timestamp":1738157174000},"page":"2489-2496","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Platelet Concentration Explains Variability in Outcomes of Platelet-Rich Plasma for Lateral Epicondylitis: A High Dose Is Critical for a Positive Response: A Systematic Review and Meta-analysis With Meta-regression"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-4373","authenticated-orcid":false,"given":"Jacob F.","family":"Oeding","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8943-0987","authenticated-orcid":false,"given":"Nathan H.","family":"Varady","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caden J.","family":"Messer","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S.","family":"Dines","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2991-7173","authenticated-orcid":false,"given":"Riley J.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-9880","authenticated-orcid":false,"given":"Scott A.","family":"Rodeo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B9.29285"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/230949901502300102"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200801000-00004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01374"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.12703\/b\/9-16"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738110366385"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094387"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2018-100356"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509349921"},{"issue":"6","key":"e_1_3_2_12_2","first-page":"502","article-title":"Efficacy of platelet-rich plasma as conservative treatment in orthopaedics: a systematic review and meta-analysis","volume":"16","author":"Franchini M","year":"2018","unstructured":"Franchini M, Cruciani M, Mengoli C, et al. 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