{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:48:55Z","timestamp":1791607735277,"version":"4.3.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"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":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lateral epicondylosis is a degenerative condition affecting 1% to 3% of adults annually. Concerns over the sustained efficacy of corticosteroids have increased interest in regenerative treatments like platelet-rich plasma (PRP), prolotherapy, and extracorporeal shockwave therapy (ESWT), but comparative data remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate whether PRP, prolotherapy, and ESWT provide superior clinical outcomes at 24 months compared with physiotherapy alone in patients with chronic lateral epicondylosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled trial; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adults older than 35 years with lateral elbow pain lasting &gt;6 months, diagnosed via physical examination and ultrasound, and refractory to at least 3 months of nonoperative treatment, were included. Exclusion criteria included recent corticosteroid or botulinum toxin injections and complete extensor tendon rupture. Patients were randomized into 4 treatment groups: physiotherapy, ESWT, prolotherapy, or PRP. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) score, and the secondary outcome was the Subjective Satisfaction Score (SSS). Patients were followed for 2 years to assess the treatment efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 231 patients were enrolled, with 202 completing the study. Baseline DASH scores were comparable across the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .526). At 24 months, PRP significantly reduced DASH scores by 31.18 points compared with physiotherapy (18.70 points) and ESWT (17.62 points) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). Prolotherapy (21.02 points) also showed greater improvement than physiotherapy at 18 months (15.61 points) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). PRP yielded the highest SSS (4.60 \u00b1 0.9), outperforming physiotherapy (3.00 \u00b1 1.9) and ESWT (3.43 \u00b1 1.7) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). Prolotherapy also yielded higher SSS (4.24 \u00b1 1.2) compared with physiotherapy (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) and ESWT (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) at 24 months. At 24 months, all groups demonstrated DASH score reductions exceeding the minimal clinically important difference of 10 points, indicating clinically meaningful improvement: PRP (31.18), prolotherapy (20.70), ESWT (17.62), and physiotherapy (18.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PRP and prolotherapy yielded better clinical and functional outcomes than ESWT and physiotherapy in chronic lateral epicondylosis over a 2-year follow-up. The findings support the potential of these therapies as effective nonsurgical options for long-standing cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251361515","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T21:28:02Z","timestamp":1755293282000},"page":"2707-2714","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Comparing the Use of Physiotherapy, Shockwave Therapy, Prolotherapy, and Platelet-Rich Plasma for Chronic Lateral Epicondylosis: A Prospective, Randomized Controlled Trial With 2-Year Follow-up"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8881-7506","authenticated-orcid":false,"given":"Sang-Hoon","family":"Lhee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, CM General Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang","family":"Ryeol Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do","family":"Young Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, CM General Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-1130(01)80043-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/22.2.73"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.05.011"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510390780"},{"key":"e_1_3_2_6_2","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988","unstructured":"Cohen J. 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