Comparison of extracorporeal shockwave therapy, ultrasound therapy, and corticosteroid injections for treatment of lateral epicondylitis: an umbrella review of meta-analyses

作者：Pengcheng Zhu, Pengyue Tang, Jingyue Su, Yixin Yang, Shengwu Yang, Chunwu Zhang, Wenfeng Xiao, Yang Zhou, Yusheng Li, Zhenhan Deng · 发表于：Journal of Orthopaedics and Traumatology · 年份：2025 · DOI：10.1186/s10195-025-00871-w · 被引用次数：6 · 研究领域：Tendon Structure and Treatment、Myofascial pain diagnosis and treatment、Sports injuries and prevention

The purpose of this study was to assess the methodological quality of meta-analyses (MAs) and resolve evidence inconsistencies by quantifying overlap in primary studies, thereby providing enhanced evidence on the efficacy of extracorporeal shockwave therapy (ESWT) versus placebo, ultrasound therapy, and corticosteroid injections for lateral epicondylitis. We conducted searches in four databases: PubMed, Embase, Cochrane Library, and Web of Science, until August 2024. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) graded the quality and reliability of the MAs, and the quality of outcomes was graded by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Graphical Representation of Overlap for OVErviews (GROOVE) was applied to analyze overlap and classified the resulting evidence into four categories (I–IV) on the basis of evidence classification criteria. A total of nine MAs were included for analysis: five had a high AMSTAR 2 rating, three had a moderate AMSTAR 2 rating, and one had a low AMSTAR 2 rating. GROOVE analysis revealed substantial overlap, informing evidence classification. ESWT can effectively reduce the pain assessed by the visual analogue scale (VAS) compared with placebo (MD = −0.68; 95% CI −1.06, −0.3; P = 0.0004; I 2 = 75%). Compared with ultrasound therapy, ESWT has a significantly large reduction in the level ...