#56: I Posted a Meta-Analysis and 50 Doctors Told Me I Was Wrong

I posted a meta-analysis showing PRP doesn't beat saline for tennis elbow. The regenerative medicine community came for me, hard. This episode walks through the incident, what the evidence states, why the comparator you choose determines the conclusion you reach, and what the pushback reveals about incentives in musculoskeletal medicine.

References

Antunes Júnior et al. (2026). 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. American Journal of Sports Medicine.

Coombes BK et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. The Lancet, 376(9754), 1751–1767.

Gosens T et al. (2011). Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year follow-up. American Journal of Sports Medicine, 39(6), 1200–1208.

Kamble P et al. (2023). Is ultrasound (US)-guided platelet-rich plasma injection more efficacious as a treatment modality for lateral elbow tendinopathy than US-guided steroid injection? A prospective triple-blinded study with midterm follow-up. Clinics in Orthopedic Surgery, 15(3), 454–462.

Krogh TP et al. (2013). Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: A randomized, double-blind, placebo-controlled trial. American Journal of Sports Medicine, 41(3), 625–635.

Oeding JF et al. (2025). 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. American Journal of Sports Medicine, 53(10), 2489–2496.

Orchard JW. (2025). Rock, paper, scissors: Resolving the conflicting results of randomized trials involving corticosteroid, platelet rich plasma (PRP) and placebo injections. JSAMS Plus, 5, 100081.

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