Wang Chenglong, Zhang Zhuo, Ma Yihang, Liu Xiangji, Zhu Qingsan
Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China.
Medicine (Baltimore). 2021 Feb 19;100(7):e24680. doi: 10.1097/MD.0000000000024680.
To explore the effectiveness of platelet-rich plasma (PRP) injection regarding functional recovery, pain relief, and range of motion (ROM) of shoulder compared with the corticosteroid injection in patients with rotator cuff lesions treated non-operatively.
An electronic literature search was performed by 2 authors in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant randomized controlled trial (RCTs) that were published up to July 20, 2020. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect sizes.
Six RCTs were included in this systematic review. Meta-analysis revealed that corticosteroid injection yielded statistically significant superior functional recovery (SMD = -0.80; 95% CI, -1.42 to -0.18; P = .01) and pain relief (MD = 1.59; 95% CI, 0.30-2.89; P = .02) compared with PRP injection for rotator cuff lesions during the short-term follow-up period. However, at the medium-term and long-term follow-up, no statistically significant difference was identified between the 2 groups. Regarding the ROM of shoulder, no statistically significant difference was found between the 2 groups during the whole follow-up period.
The current clinical evidence revealed short-term efficacy of corticosteroid injection and no significant medium- to long-term difference between corticosteroid and PRP injection in the treatment of rotator cuff lesions. Additional studies with longer follow-ups, larger sample sizes, and more rigorous designs are needed to draw more reliable and accurate conclusions.
探讨与皮质类固醇注射相比，富血小板血浆（PRP）注射对非手术治疗的肩袖损伤患者功能恢复、疼痛缓解及肩关节活动范围（ROM）的有效性。
由2位作者在PubMed、Embase、Cochrane图书馆和Web of Science数据库中进行电子文献检索，以识别截至2020年7月20日发表的相关随机对照试验（RCT）。使用Cochrane干预系统评价手册推荐的方法评估纳入的RCT的质量。应用标准化均数差（SMD）或均数差（MD）及95%置信区间（CI）计算合并效应量。
本系统评价纳入6项RCT。荟萃分析显示，在短期随访期间，与PRP注射相比，皮质类固醇注射在肩袖损伤患者中产生了统计学上显著更好的功能恢复（SMD = -0.80；95% CI，-1.42至-0.18；P = 0.01）和疼痛缓解（MD = 1.59；95% CI，0.30 - 2.89；P = 0.02）。然而，在中期和长期随访中，两组之间未发现统计学上的显著差异。关于肩关节活动范围，在整个随访期间两组之间未发现统计学上的显著差异。
目前的临床证据显示皮质类固醇注射具有短期疗效，在治疗肩袖损伤方面，皮质类固醇注射与PRP注射在中长期无显著差异。需要进行更多随访时间更长、样本量更大且设计更严谨的研究，以得出更可靠和准确的结论。
