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Arthritis Care Res (Hoboken). 2016 Nov;68(11):1681-1687. doi: 10.1002/acr.22874.

Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis.

Author information

1
AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, and Versailles St-Quentin University, INSERM, Villejuif, France. alexis.descatha@inserm.fr.
2
AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, France.
3
Versailles St-Quentin University, INSERM; Versailles St-Quentin University, INSERM, Villejuif, France.
4
Versailles St-Quentin University, INSERM, Villejuif, and AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny, France.
5
LUNAM Université and Université d'Angers, Angers, France.
6
Versailles St-Quentin University, INSERM, Villejuif, and INRS, Vandœuvre-lès-Nancy, France.

Abstract

OBJECTIVE:

In view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work.

METHODS:

Using the key words "lateral epicondylitis" AND "occupational" AND ("cohort" OR "longitudinal," OR "incidence") without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Données de Santé Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]).

RESULTS:

From 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q = 1.4, P > 0.05). Funnel plots and Egger's test did not suggest major publication bias.

CONCLUSION:

The results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.

PMID:
26946473
DOI:
10.1002/acr.22874
[Indexed for MEDLINE]
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