Ali Mohammed, Oderuth Eshan, Atchia Ismael, Malviya Ajay
Trauma and Orthopedics, Northumbria Healthcare NHS foundation Trust, North Shields, UK.
Chesterfield Royal Hospital, Chesterfield, UK.
J Hip Preserv Surg. 2018 Aug 30;5(3):209-219. doi: 10.1093/jhps/hny027. eCollection 2018 Aug.
This review aims to determine whether platelet-rich plasma (PRP) has any role in improving clinical outcomes in patients with symptomatic greater trochanteric pain syndrome (GTPS). A search of NICE healthcare database advanced search (HDAS) via Athens (PubMed, MEDLINE, CINAHL, EMBASE and AMED databases) was conducted from their year of inception to April 2018 with the keywords: 'greater trochanteric pain syndrome' or 'GTPS' or 'gluteus medius' or 'trochanteric bursitis' and 'platelet rich plasma' (PRP). A quality assessment was performed using the JADAD score for RCTs and MINORS for non-RCT studies. Five full-text articles were included for analysis consisting of three RCTs and two case series. We also identified four additional studies from published conference abstracts (one RCT and three case series). The mean age in 209 patients was 58.4 years (range 48-76.2 years). The majority of patients were females and the minimum duration of symptoms was three months. Diagnosis was made using ultrasound or MRI. Included studies used a variety of outcome measures. Improvement was observed during the first 3 months after injection. Significant improvement was also noted when patients were followed up till 12 months post treatment. PRP seems a viable alternative injectable option for GTPS refractory to conservative measures. The current literature has revealed that PRP is relatively safe and can be effective Considering the limitations in these studies, more large-sample and high-quality randomized clinical trials are required in the future to provide further evidence of the efficacy for PRP as a treatment in GTPS.
PROSPERO CRD42017080662.
Level I, systematic review of Level I studies.
本综述旨在确定富血小板血浆（PRP）在改善有症状的大转子疼痛综合征（GTPS）患者的临床结局方面是否有任何作用。通过雅典检索NICE医疗保健数据库高级搜索（HDAS）（PubMed、MEDLINE、CINAHL、EMBASE和AMED数据库），从其创建年份至2018年4月，使用关键词：“大转子疼痛综合征”或“GTPS”或“臀中肌”或“转子滑囊炎”以及“富血小板血浆”（PRP）。使用JADAD评分对随机对照试验（RCT）进行质量评估，对非RCT研究使用MINORS进行质量评估。纳入五篇全文文章进行分析，包括三项RCT和两个病例系列。我们还从已发表的会议摘要中确定了另外四项研究（一项RCT和三个病例系列）。209例患者的平均年龄为58.4岁（范围48 - 76.2岁）。大多数患者为女性，症状最短持续时间为三个月。通过超声或MRI进行诊断。纳入的研究使用了多种结局指标。注射后前3个月观察到改善。在治疗后随访至12个月时也注意到显著改善。对于保守治疗无效的GTPS，PRP似乎是一种可行的替代注射选择。当前文献表明PRP相对安全且可能有效。考虑到这些研究的局限性，未来需要更多大样本和高质量的随机临床试验，以提供PRP作为GTPS治疗方法有效性的进一步证据。
PROSPERO CRD42017080662。
I级，I级研究的系统评价。
