Aw Angeline Ai Ling, Leeu Jun Jie, Tao Xinyu, Bin Abd Razak Hamid Rahmatullah
Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921, Singapore.
Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
J Exp Orthop. 2021 Nov 4;8(1):101. doi: 10.1186/s40634-021-00415-1.
This study aims to compare the efficacy of a dual therapy of Platelet-Rich Plasma (PRP) and Hyaluronic Acid (HA) compared with PRP-alone therapy in the treatment of knee osteoarthritis (KOA).
PubMed, Embase, CINAHL, SCOPUS, Cochrane Library, grey literature and bibliographic references were searched from inception to January 2021. Only randomized controlled trials (RCTs) and retrospective cohort studies comparing the effect of PRP and HA versus PRP-alone therapy for KOA were included. Literature retrieval and data extraction were conducted by three independent reviewers. Pooled analysis of Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), International Knee Documentation Committee (IKDC) scores and adverse events were conducted.
Ten studies (7 RCTs, 3 cohort studies) involving 983 patients were covered. Dual PRP and HA therapy resulted in significant reduction in VAS compared to PRP-alone therapy at 4-6 weeks (P < 0.00001) and 12 months (P < 0.00001). Dual therapy resulted in better WOMAC score improvement at 3 (P = 0.02), 6 (P = 0.05) and 12 months (P < 0.0001) compared to PRP-alone therapy. The IKDC score for dual therapy was also higher at 6 months compared to PRP-alone therapy (P = 0.007). Regarding adverse events, dual therapy was generally safer than PRP-alone therapy (P = 0.02).
While there is a paucity of large high-quality Level I studies, current best evidence suggests that dual therapy with PRP and HA for KOA may be effective at providing pain relief and improvement in function up to 1 year following administration.
II.
本研究旨在比较富含血小板血浆（PRP）与透明质酸（HA）联合治疗与单纯PRP治疗在膝关节骨关节炎（KOA）治疗中的疗效。
检索了从数据库建立至2021年1月的PubMed、Embase、CINAHL、SCOPUS、Cochrane图书馆、灰色文献和参考文献。仅纳入比较PRP与HA联合治疗和单纯PRP治疗对KOA疗效的随机对照试验（RCT）和回顾性队列研究。由三名独立的审阅者进行文献检索和数据提取。对视觉模拟量表（VAS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、国际膝关节文献委员会（IKDC）评分及不良事件进行汇总分析。
共纳入10项研究（7项RCT、3项队列研究），涉及983例患者。与单纯PRP治疗相比，PRP与HA联合治疗在4 - 6周（P < 0.00001）和12个月（P < 0.00001）时VAS显著降低。与单纯PRP治疗相比，联合治疗在3个月（P = 0.02）、6个月（P = 0.05）和12个月（P < 0.0001）时WOMAC评分改善更明显。联合治疗在6个月时的IKDC评分也高于单纯PRP治疗（P = 0.007）。关于不良事件，联合治疗总体上比单纯PRP治疗更安全（P = 0.02）。
虽然缺乏大量高质量的I级研究，但目前的最佳证据表明，PRP与HA联合治疗KOA在给药后长达1年可能有效缓解疼痛并改善功能。
II级。
