The efficacy of Botulinum Toxin in Tennis Elbow: a meta-analysis of randomized clinical trials.

IF 2 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-12-01 Epub Date: 2024-09-30 DOI:10.1007/s00264-024-06339-6

Eduardo Silva Reis Barreto, César Romero Antunes Júnior, Vinícius Borges Alencar, Márcio Passos Leandro, Luiz Marcelo Bastos Leite, Liliane Elze Falcão Lins-Kusterer, Durval Campos Kraychete

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Abstract

Purpose: This study aims to assess the efficacy of botulinum toxin type A (BT-A) in treating tennis elbow.

Methods: We systematically reviewed the literature and included full-text randomized clinical trials (RCTs) published until June 2024, available in PubMed, Scopus, Embase, and Cochrane CENTRAL databases. Eligible studies involved patients with tennis elbow and compared BT-A with placebo or other injectable treatments. Primary outcomes included pain relief, while secondary outcomes assessed quality of life, adverse effects, and grip strength. The risk of bias was evaluated using the Cochrane Risk of Bias tool.

Results: Seven RCTs with a total of 381 patients were included. The participants were predominantly middle-aged (mean age 46.64 ± 7.72 years) and diagnosed with chronic tennis elbow. BT-A doses ranged from 20U to 60U. Compared to placebo, BT-A effectively reduced pain at two to four weeks (MD = -1.37; 95% CI = -2.18 to -0.57) and at eight to 12 weeks (MD = -1.13; 95% CI = -1.62 to -0.65). Grip strength was comparable between the BT-A and placebo groups at both time points (2 to 4 weeks: SMD = -0.86; 95% CI -1.78 to 0.05; 8 to 12 weeks: SMD = 0.00; 95% CI = -0.95 to 0.95).

Conclusion: This meta-analysis suggests that BT-A reduces pain in tennis elbow within two to 12 weeks compared to placebo. Findings are limited by study size, and further research is needed to confirm its efficacy and safety.

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肉毒杆菌毒素对网球肘的疗效：随机临床试验荟萃分析。

目的：本研究旨在评估 A 型肉毒毒素（BT-A）治疗网球肘的疗效：我们系统地查阅了相关文献，并纳入了截至 2024 年 6 月发表在 PubMed、Scopus、Embase 和 Cochrane CENTRAL 数据库中的全文随机临床试验（RCT）。符合条件的研究涉及网球肘患者，并对 BT-A 与安慰剂或其他注射疗法进行了比较。主要结果包括疼痛缓解，次要结果包括生活质量、不良反应和握力。使用 Cochrane 偏倚风险工具对偏倚风险进行了评估：结果：共纳入了七项 RCT，共有 381 名患者。参与者主要为中年人（平均年龄为 46.64 ± 7.72 岁），被诊断为慢性网球肘。BT-A 剂量从 20U 到 60U 不等。与安慰剂相比，BT-A能有效减轻2至4周的疼痛（MD = -1.37; 95% CI = -2.18 to -0.57）和8至12周的疼痛（MD = -1.13; 95% CI = -1.62 to -0.65）。在两个时间点，BT-A 组和安慰剂组的握力相当（2 至 4 周：SMD = -0.86；95% CI -1.78 至 0.05；8 至 12 周：结论：这项荟萃分析表明，与安慰剂相比，BT-A 可在 2 至 12 周内减轻网球肘患者的疼痛。研究结果受研究规模的限制，还需要进一步的研究来确认其疗效和安全性。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.