Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Department of Orthopaedic Surgery, St Joseph's University Medical Center, Paterson, New Jersey, USA.
Am J Sports Med. 2021 Jan;49(1):249-260. doi: 10.1177/0363546520909397. Epub 2020 Apr 17.
BACKGROUND: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are 2 nonoperative treatment options for knee osteoarthritis (OA) that are supposed to provide symptomatic relief and help delay surgical intervention. PURPOSE: To systematically review the literature to compare the efficacy and safety of PRP and HA injections for the treatment of knee OA. STUDY DESIGN: Meta-analysis of level 1 studies. METHODS: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify level 1 studies that compared the clinical efficacy of PRP and HA injections for knee OA. The search phrase used was . Patients were assessed via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and Subjective International Knee Documentation Committee (IKDC) scale. A subanalysis was also performed to isolate results from patients who received leukocyte-poor and leukocyte-rich PRP. RESULTS: A total of 18 studies (all level 1) met inclusion criteria, including 811 patients undergoing intra-articular injection with PRP (mean age, 57.6 years) and 797 patients with HA (mean age, 59.3 years). The mean follow-up was 11.1 months for both groups. Mean improvement was significantly higher in the PRP group (44.7%) than the HA group (12.6%) for WOMAC total scores ( < .01). Of 11 studies based on the VAS, 6 reported PRP patients to have significantly less pain at latest follow-up when compared with HA patients ( < .05). Of 6 studies based on the Subjective IKDC outcome score, 3 reported PRP patients to have significantly better scores at latest follow-up when compared with HA patients ( < .05). Finally, leukocyte-poor PRP was associated with significantly better Subjective IKDC scores versus leukocyte-rich PRP ( < .05). CONCLUSION: Patients undergoing treatment for knee OA with PRP can be expected to experience improved clinical outcomes when compared with HA. Additionally, leukocyte-poor PRP may be a superior line of treatment for knee OA over leukocyte-rich PRP, although further studies are needed that directly compare leukocyte content in PRP injections for treatment of knee OA.
背景：富血小板血浆（PRP）和透明质酸（HA）是两种非手术治疗膝骨关节炎（OA）的方法，旨在提供症状缓解并有助于延迟手术干预。 目的：系统地回顾文献，比较 PRP 和 HA 注射治疗膝 OA 的疗效和安全性。 研究设计：1 级研究的荟萃分析。 方法：通过搜索 PubMed、Cochrane 图书馆和 Embase 来进行系统评价，以确定比较 PRP 和 HA 注射治疗膝 OA 的临床疗效的 1 级研究。使用的搜索词是. 患者通过 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）、疼痛视觉模拟量表（VAS）和主观国际膝关节文献委员会（IKDC）量表进行评估。还进行了亚分析，以分离接受白细胞减少和白细胞丰富的 PRP 的患者的结果。 结果：共有 18 项研究（均为 1 级）符合纳入标准，包括 811 例接受关节内注射 PRP（平均年龄 57.6 岁）和 797 例接受 HA（平均年龄 59.3 岁）的患者。两组的平均随访时间均为 11.1 个月。PRP 组的 WOMAC 总分平均改善率（44.7%）明显高于 HA 组（12.6%）（<.01）。在基于 VAS 的 11 项研究中，有 6 项报告 PRP 患者在最新随访时疼痛明显减轻，与 HA 患者相比（<.05）。在基于主观 IKDC 结果评分的 6 项研究中，有 3 项报告 PRP 患者在最新随访时评分明显优于 HA 患者（<.05）。最后，白细胞减少的 PRP 与白细胞丰富的 PRP 相比，主观 IKDC 评分明显更好（<.05）。 结论：与 HA 相比，接受 PRP 治疗膝 OA 的患者的临床结局有望得到改善。此外，白细胞减少的 PRP 可能是治疗膝 OA 的一种优于白细胞丰富的 PRP 的治疗方法，尽管需要进一步的研究来直接比较 PRP 注射治疗膝 OA 的白细胞含量。
J Orthop Surg Res. 2020-9-11
Int J Pharm X. 2025-8-10
Front Physiol. 2025-7-2
J Funct Morphol Kinesiol. 2025-4-21
J Funct Morphol Kinesiol. 2025-3-26
Front Bioeng Biotechnol. 2025-4-24
Zotero 插件