Italian National Blood Centre, National Institute of Health, Rome, Italy.
Department of Haematology and Transfusion Medicine, "Carlo Poma" Hospital, Mantua, Italy.
Blood Transfus. 2018 Nov;16(6):502-513. doi: 10.2450/2018.0111-18. Epub 2018 Sep 3.
The aim of this systematic review and meta-analysis was to evaluate the benefit of platelet-rich plasma (PRP) in non-surgical orthopaedic procedures.
We searched the Cochrane Wounds Specialized Register, CENTRAL, MEDLINE (through PUBMED), Embase, and SCOPUS. We also searched clinical trials registries for ongoing and unpublished studies and checked reference lists to identify additional studies.
We found 36 randomised controlled trials (2,073 patients) that met our inclusion criteria. The included studies mostly had small numbers of participants (from 20 to 225). Twenty-eight studies included patients with lateral epicondylitis or plantar fasciitis. PRP was compared to local steroids injection (19 studies), saline injection (6 studies), autologous whole blood (4 studies), local anaesthetic injection (3 studies), dry needling injection (3 studies), and to other comparators (4 studies). Primary outcomes were pain and function scores, and adverse events. On average, it is unclear whether or not use of PRP compared to controls reduces pain scores and functional score at short- (up to 3 months) and medium- (4-6 months) term follow-up. The available evidence for all the comparisons was rated as very low quality due to inconsistency, imprecision, and risk of bias in most of the selected studies. There were no serious adverse events related to PRP injection or control treatments.
The results of this meta-analysis, which documents the very marginal effectiveness of PRP compared to controls, does not support the use of PRP as conservative treatment in orthopaedics.
本系统评价和荟萃分析的目的是评估富血小板血浆（PRP）在非手术骨科治疗中的益处。
我们检索了 Cochrane 伤口专业注册库、CENTRAL、MEDLINE（通过 PUBMED）、Embase 和 SCOPUS。我们还检索了临床试验注册库，以查找正在进行和未发表的研究，并检查了参考文献列表以确定其他研究。
我们发现了 36 项符合纳入标准的随机对照试验（2073 名患者）。纳入的研究大多参与者人数较少（20-225 人）。28 项研究纳入了外侧肱骨上髁炎或足底筋膜炎患者。PRP 与局部皮质类固醇注射（19 项研究）、生理盐水注射（6 项研究）、自体全血（4 项研究）、局部麻醉注射（3 项研究）、干针注射（3 项研究）和其他对照物（4 项研究）进行了比较。主要结局是疼痛和功能评分以及不良事件。平均而言，与对照组相比，使用 PRP 是否能降低短期（3 个月内）和中期（4-6 个月）随访时的疼痛评分和功能评分尚不清楚。由于大多数选定研究的一致性、不准确性和偏倚风险，所有比较的证据质量均被评为极低。PRP 注射或对照治疗均无严重不良事件。
本荟萃分析的结果表明，与对照组相比，PRP 的效果非常有限，因此不支持将 PRP 作为骨科的保守治疗方法。
