The clinical impact of platelet-rich plasma on tendinopathy compared to placebo or dry needling injections: A meta-analysis

•PRP was not significantly superior to placebo or dry needling on tendinopathy.•PRP was marginally more effective than controls on rotator cuff tendinopathy.•The effects of potential sources of clinical diversity should be investigated.

ObjectiveThe purpose of this meta-analysis was to compare the impact of platelet-rich plasma with that of placebo or dry needling injections on tendinopathy.MethodsThe databases of PubMed, CENTRAL, Scopus, Web of Science, and trial registries, reference lists, and conference abstract books were searched up to December 2014. Adults with tendinopathy in randomized controlled trials were enrolled. The trials compared effect of platelet-rich plasma with that of placebo or dry needling. We used subgroup analysis linked to the anatomical location of the tendinopathy. The primary outcome was pain intensity at two or three and six months after intervention. The secondary outcome was functional disability at three months after treatment.ResultsFive trials were included. There was a statistically significant difference in favor of the platelet-rich plasma intervention at the second primary outcome time point (SMD −0.48, 95%CIs −0.86 to −0.10, I2 = 0%, p = 0.01) and at the secondary outcome time point (SMD −0.47, 95%CIs −0.85 to −0.09, I2 = 0%, p=0.01).ConclusionsPlatelet-rich plasma did not provide significantly greater clinical benefit versus placebo or dry needling for the treatment of tendinopathy at a six-month follow-up. However, there was a marginal clinical difference in favor of platelet-rich plasma injections on rotator cuff tendinopathy.