Orthopedics Department, Beijing Changping Hospital of Intergrated Chinese and Western Medicine.
General Orthopedics Department, Wangjing Hospital of CACMS, Beijing.
Medicine (Baltimore). 2021 Mar 26;100(12):e25168. doi: 10.1097/MD.0000000000025168.
: Knee osteoarthritis (KOA) is the most common degenerative disease of the joints caused by articular cartilage injury, degeneration of joint edges and hyperplasia of subchondral bone. The purpose of this study is to investigate the efficacy and safety of clinical therapy of platelet-rich plasma vs hyaluronic acid injections in patients with KOA.
: We systematically investigated Pubmed, Embase, and the Cochrane Library for all related articles published through May 2020. Any study was included that compared the effect of platelet-rich plasma (PRP) and hyaluronic acid (HA) in patients with KOA. The search terms included “platelet-rich plasma,” “PRP,” “hyaluronic acid,” “HA,” “knee,” “osteoarthritis,” “arthritis,” “KOA”. Review Manager 5.3 was used to analyze and calculate data regarding these outcome indicators.
: In this study, 1. Six randomized doubleblind controlled trials were included, including 338 patients in the PRP group and 323 patients in the HA group. 2. Meta-analysis results showed that the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) Total Score was differed significantly between the PRP and HA groups at the 1, 6, 12 months follow-up (MD = 3.39, 95% CI: 2.85–3.92, < .05). In a comparison of Physical function scores at the 12 months follow-up, PRP improved knee function scores more than HA (MD = 3.28; 95% CI: 2.13–4.43; < .05). However, International Knee Documentation Committee (IKDC), Tegner Activity scores, EuroQol visual analogue scale (EQ-VAS), and Adverse Events (AEs) were all not significantly different ( > .05). 3. Results showed that compared with HA, PRP had significant advantages in relevant improving knee function and quality of life.
: In improving knee function and quality of life, PRP showed superiority over HA in long-term follow-up from well-designed double-blind trials, but a large number of high-quality multi-center studies are still needed to provide more sufficient evidence.
膝骨关节炎（KOA）是由关节软骨损伤、关节边缘退变和软骨下骨增生引起的最常见的关节退行性疾病。本研究旨在探讨富血小板血浆（PRP）与透明质酸（HA）注射治疗 KOA 患者的临床疗效和安全性。
我们系统地检索了 Pubmed、Embase 和 Cochrane 图书馆，以获取截至 2020 年 5 月发表的所有相关文章。纳入的研究比较了 PRP 和 HA 治疗 KOA 患者的疗效。检索词包括“platelet-rich plasma”、“PRP”、“hyaluronic acid”、“HA”、“knee”、“osteoarthritis”、“arthritis”、“KOA”。使用 Review Manager 5.3 分析和计算这些结局指标的数据。
本研究中，1. 纳入了 6 项随机双盲对照试验，PRP 组 338 例，HA 组 323 例。2. 荟萃分析结果显示，PRP 和 HA 组在 1、6、12 个月随访时的 Western Ontario and MacMaster Universities Osteoarthritis Index（WOMAC）总评分有显著差异（MD = 3.39，95%CI：2.85-3.92， < .05）。在 12 个月随访时的生理功能评分比较中，PRP 改善膝关节功能评分优于 HA（MD = 3.28；95%CI：2.13-4.43； < .05）。然而，国际膝关节文献委员会（IKDC）、Tegner 活动评分、欧洲五维健康量表视觉模拟评分（EQ-VAS）和不良事件（AEs）均无显著差异（ > .05）。3. 结果表明，与 HA 相比，PRP 在改善膝关节功能和生活质量方面具有显著优势。
在改善膝关节功能和生活质量方面，PRP 在长期随访中优于 HA，来自设计良好的双盲试验，但仍需要大量高质量的多中心研究提供更充分的证据。
