Platelet-Rich Plasma Does Not Improve Pain or Function in Patients With Lateral Epicondylitis as Compared With Placebo: A Meta-analysis of Randomized Clinical Trials
In tennis elbow, platelet-rich plasma did not improve pain or function versus placebo.
*Systematic review and meta-analysis of randomized trials; Level 1a (OCEBM).
*Systematic review and meta-analysis of randomized trials; Level 1a (OCEBM).
Citation
Antunes Júnior CRA, Santos RSSS, Barreto ESR, et al. Platelet-Rich Plasma Does Not Improve Pain or Function in Patients With Lateral Epicondylitis as Compared With Placebo: A Meta-analysis of Randomized Clinical Trials. The American Journal of Sports Medicine. 2026;54(5):1247–1257. doi:10.1177/03635465251383039
Background
Tennis elbow is a common cause of outer-elbow pain and reduced hand use. Platelet-rich plasma injections are widely used, but trial results have been mixed.
Patients
Adults with tennis elbow (mostly symptoms for at least 3 months). Excluded: non-randomized studies, non-placebo comparators, and reports without usable data.
Intervention
Platelet-rich plasma injection (varied preparation methods, doses, and injection techniques; some trials used multiple injections).
Control
Placebo injection (normal saline) or sham injection.
Outcome
Primary: pain and arm function. Secondary: adverse events and grip strength.
Follow-up Period
Meta-analysis timepoints: 4 weeks, 8–12 weeks, and 24–26 weeks (individual trials followed participants 8–54 weeks).
Results
Six randomized trials (355 patients) were included. Across all timepoints, platelet-rich plasma showed no meaningful advantage over placebo for pain or function. Adverse events were similar between groups and were generally short-lived (for example, injection-site pain or bruising). Grip strength and quality of life were rarely reported, limiting conclusions for those outcomes.
Limitations
Trials differed in how platelet-rich plasma was prepared and injected, and how outcomes were measured. One trial was not blinded. Few trials reported grip strength, and none reported quality of life.
Funding
Not reported; authors declared no conflicts of interest.
Clinical Application
For tennis elbow, avoid routine platelet-rich plasma injections; prioritize proven options (exercise-based therapy, activity modification, and pain control) unless new high-quality evidence emerges.
Discussion
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In this systematic review/meta-analysis of 6 RCTs, PRP vs placebo did not improve lateral epicondylitis pain at 24–26 weeks (MD −1.58; 95% CI −4.74 to 1.58) or function; are the trials valid and applicable enough to stop offering PRP in practice? In this meta-analysis of RCTs, pain at 8–12 weeks had an SMD of −0.36 with a 95% CI from −0.99 to 0.27. Which is the best interpretation?