Stem cell therapy for the management of lateral elbow tendinopathy: A systematic literature review

Purpose. - Lateral elbow tendinopathy is the most common cause of lateral elbow pain with a lifetime prevalence of approximately 40% in the general population. The purpose of this study was to complete a systematic review to identify the potential of stem cell therapy based on the current evidence in the treatment of lateral elbow tendinopathy. Methodology. - A systematic review through the Ovid, Medline, and Cochrane Review databases was performed with the search terms of lateral epicondylitis, tendinopathy, tennis elbow, stem cell, bone marrow, treatment, and therapy. Results. - The systematic review initially identified 816 articles from three databases. Five studies met the inclusion criteria. The five studies evaluated four different stem cell preparations including autologous tenocytes, skin-derived tenocyte-like cells, allogeneic adipose-derived mesenchymal stem cells, and bone marrow aspirate. Conclusion. - While a majority of lateral elbow tendinopathy cases resolve in a timely manner with no or limited intervention, recovery can be a delayed process for a small percentage of patients. The role of emerging treatment options has not been established. Stem cell therapy is an option for refractory cases, but current evidence is poor. Early findings demonstrated significant improvements in imaging and functional outcomes, but findings were limited by lack of control arms or other treatment arms for comparison. Further large, controlled studies are needed to evaluate safety, efficacy in order to establish the role of stem cell therapy in the management of lateral elbow tendinopathy. (C) 2020 Elsevier Masson SAS. All rights reserved.