Evidence map›Paper›PMID 40824407›Full record

SynthesisJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2025

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

Pengcheng Zhu, Peiyuan Tang, Jingyue Su, Yixin Yang, Shengwu Yang, Chunwu Zhang, Wenfeng Xiao, Yang Zhou, Yusheng Li, Zhenhan Deng

Abstract readSystematic ReviewComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Pengcheng Zhu *Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China.
Peiyuan Tang *Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China.
Jingyue SuDepartment of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Yixin YangDepartment of Epidemiology, University of California, Los Angeles, USA.
Shengwu YangDepartment of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Chunwu ZhangDepartment of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Wenfeng XiaoDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China.
Yang ZhouDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China. zhouyangcch@163.com.
Yusheng LiDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China. liyusheng@csu.edu.cn.
Zhenhan DengDepartment of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China. dengzhenhan@wmu.edu.cn.ORCID http://orcid.org/0000-0003-0522-8269

Funding

Hunan Provincial Science Fund for Distinguished Young Scholars 2024JJ2089National Clinical Research Center for Geriatric Disorders 2021LNJJ05National Clinical Research Center for Geriatric Disorders Grant no. 2021KFJJ02National Clinical Research Center for Geriatric Disorders Xiangya HospitalNational Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation 2021-NCRC-CXJJ-PY-40National Key R&D Program of China 2019YFA0111900National Key R&D Program of China 2023YFC3603400National Natural Science Foundation of China 82272611National Natural Science Foundation of China 92268115National Natural Science Foundation of China No. 882072506Science and Technology Innovation Program of Hunan Province No. 2021JJ31105
6 · The paper itself

Abstract

backgroundThe 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.

methodsWe 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.

resultsA 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

conclusionsESWT has a significant difference in reducing pain evaluation and relief of pain symptoms, and the effect is better than ultrasound therapy and corticosteroid injections. LEVEL OF EVIDENCE I: THIS PROTOCOL HAS BEEN REGISTERED IN THE PROSPERO DATABASE: CRD42024586419.

Indexed as

Adrenal Cortex HormonesExtracorporeal Shockwave TherapyTennis ElbowUltrasonic TherapyHumansMeta-Analysis as TopicAdrenal Cortex HormonesCorticosteroid injectionExtracorporeal shockwave therapyLateral epicondylitisUltrasound therapyUmbrella review

Identifiers

PMID40824407
PMCPMC12361003

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.