Krstičević Mišo, Jerić Milka, Došenović Svjetlana, Jeličić Kadić Antonia, Puljak Livia
Department of Orthopedics, University Hospital Split, Split, Croatia.
Department of Dermatovenerology, General Hospital Zadar, Zadar, Croatia.
Int Orthop. 2017 Apr;41(4):671-679. doi: 10.1007/s00264-017-3422-5. Epub 2017 Feb 11.
To systematically analyse randomised controlled trials (RCTs) about efficacy and safety of proliferative injection therapy (prolotherapy) for treatment of osteoarthritis (OA).
CENTRAL, Embase and MEDLINE were searched. Two reviewers independently conducted screening and data extraction. RCTs were assessed with the Cochrane risk of bias tool. Type of treatment, study design, dosing, efficacy outcomes and safety outcomes were analysed. The protocol was registered in PROSPERO (CRD42016035258).
Seven RCTs were included, with 393 participants aged 40-75 years and mean OA pain duration from three months to eight years. Follow-up was 12 weeks to 12 months. Studies analysed OA of the knee joint (n = 5), first carpometacarpal joint (n = 1) and finger joints (n = 1). Various types of prolotherapy were used; dextrose was the most commonly used irritant agent. All studies concluded that prolotherapy was effective treatment for OA. No serious adverse events were reported. The studies had considerable methodological limitations.
Limited evidence from low-quality studies indicates a beneficial effect of prolotherapy for OA management. The number of participants in these studies was too small to provide reliable evidence.
Current data from trials about prolotherapy for OA should be considered preliminary, and future high-quality trials on this topic are warranted.
系统分析增生注射疗法治疗骨关节炎（OA）的疗效和安全性的随机对照试验（RCT）。
检索CENTRAL、Embase和MEDLINE数据库。两名评价员独立进行筛选和数据提取。采用Cochrane偏倚风险工具对RCT进行评估。分析治疗类型、研究设计、剂量、疗效结局和安全性结局。该方案已在PROSPERO（CRD42016035258）注册。
纳入7项RCT，共393名参与者，年龄40 - 75岁，OA疼痛平均持续时间3个月至8年。随访时间为12周至12个月。研究分析了膝关节OA（n = 5）、第一掌指关节OA（n = 1）和手指关节OA（n = 1）。使用了各种类型的增生注射疗法；葡萄糖是最常用的刺激剂。所有研究均得出增生注射疗法是治疗OA的有效方法的结论。未报告严重不良事件。这些研究存在相当大的方法学局限性。
低质量研究的证据有限，表明增生注射疗法对OA治疗有益。这些研究中的参与者数量过少，无法提供可靠证据。
目前关于增生注射疗法治疗OA的试验数据应被视为初步数据，未来有必要开展关于该主题的高质量试验。
