SynthesisBMJ open sport & exercise medicine2019
How does surgery compare to sham surgery or physiotherapy as a treatment for tendinopathy? A systematic review of randomised trials.
Synthesis in BMJ open sport & exercise medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Comparative effectiveness of exercise interventions for patellar tendinopathy: a systematic review and network meta-analysis of randomized controlled trials.BMC sports science, medicine & rehabilitation · 2026Pooled it
- Effectiveness of high-intensity laser therapy for tendinopathy: a systematic review and meta-analysis of randomised controlled trials.Lasers in medical science · 2026Pooled it
- Efficacy of radiofrequency microdebridement (TOPAZ) in tendinopathy: a systematic review and meta-analysis of randomised clinical trials.Journal of orthopaedic surgery and research · 2026Pooled it
- Short-term efficacy of physical interventions for lateral epicondylitis: a network meta-analysis based on multidimensional evaluation of pain and function.Frontiers in pain research (Lausanne, Switzerland) · 2026Pooled it
- Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness.Health technology assessment (Winchester, England) · 2023Pooled it
- Proximal Hamstring Tendinopathy: A Systematic Review of Interventions.International journal of sports physical therapy · 2021Pooled it
- Do we need to improve the reporting of evidence in tendinopathy management? A critical appraisal of systematic reviews with recommendations on strength of evidence assessment.BMJ open sport & exercise medicine · 2021Pooled it
- Trial
- Achilles tendinopathy.Nature reviews. Disease primers · 2025Review
- Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- ZIF-8-loaded decellularized porcine annulus fibrosus bioadhesive enhances rotator cuff tendon-to-bone healing in a rat model.Frontiers in bioengineering and biotechnology · 2025Article
- Cell Sheet Technology: An Emerging Approach for Tendon and Ligament Tissue Engineering.Annals of biomedical engineering · 2024Review
- Current and future advances in practice: tendinopathies of the hip.Rheumatology advances in practice · 2024Review
- "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain.Physical therapy · 2023Article
- Mechanisms and therapeutic prospects of mesenchymal stem cells-derived exosomes for tendinopathy.Stem cell research & therapy · 2023Review
- Hip Tendinopathies: An Update of Concepts and Approaches.Revista brasileira de ortopedia · 2022Article
- The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review.The Journal of manual & manipulative therapy · 2021Review
- Tendinopathy.Nature reviews. Disease primers · 2021Review
- Time to put down the scalpel? The role of surgery in tendinopathy.British journal of sports medicine · 2020Article
- Recent advances in tendinopathy.Faculty reviews · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
Abstract
purposeTo assess the effectiveness of surgery on all tendinopathies by comparing it to no treatment, sham surgery and exercise-based therapies for both mid-term (12 months) and long-term (> 12 months) outcomes.
methodsOur literature search included EMBASE, Medline, CINAHL and Scopus. A combined assessment of internal validity, external validity and precision of each eligible study yielded its overall study quality. Results were considered significant if they were based on strong (Level 1) or moderate (Level 2) evidence.
results12 studies were eligible. Participants had the following types of tendinopathy: shoulder in seven studies, lateral elbow in three, patellar in one and Achilles in one. Two studies were of good, four of moderate and six of poor overall quality. Surgery was superior to no treatment or placebo, for the outcomes of pain, function, range of movement (ROM) and treatment success in the short and midterm. Surgery had similar effects to sham surgery on pain, function and range of motion in the midterm. Physiotherapy was as effective as surgery both in the midterm and long term for pain, function, ROM and tendon force, and pain, treatment success and quality of life, respectively.
conclusionWe recommend that healthcare professionals who treat tendinopathy encourage patients to comply with loading exercise treatment for at least 12 months before the option of surgery is seriously entertained.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.