Barman Apurba, Mishra Archana, Maiti Rituparna, Sahoo Jagannatha, Thakur Kaustav Basu, Sasidharan Sreeja Kamala
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
Clin Shoulder Elb. 2022 Mar;25(1):73-89. doi: 10.5397/cise.2021.00353. Epub 2021 Nov 19.
To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases.
The PubMed, Medline, and Central databases and trial registries were searched from their inception to October 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL).
A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8-12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01-14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provided better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6-7 months.
PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.
评估自体富血小板血浆（PRP）注射治疗常见肩部疾病的疗效。
检索PubMed、Medline和CENTRAL数据库以及试验注册库，检索时间从数据库创建至2020年10月，以查找自体PRP注射治疗肩部疾病与安慰剂或任何对照干预措施的随机对照试验。在结果的选择、分析和报告过程中遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。主要结局为疼痛强度（视觉模拟量表），次要结局为功能和生活质量（QoL）的变化。
共分析了17项PRP与对照的随机对照试验。从8 - 12周直至≥1年，PRP注射与比对照干预更好的疼痛缓解和功能结局相关。PRP注射还与更高的生活质量相关，在中期随访时效应大小为2.61（95%置信区间，2.01 - 14.17）。与安慰剂和皮质类固醇注射相比，PRP注射提供了更好的疼痛缓解和功能改善。在亚组分析中，采用双重离心技术制备PRP、PRP中的血小板浓度富集≥5倍、使用富含白细胞的PRP或在应用前使用激活剂的试验在6 - 7个月时报告了最有效的疼痛缓解。
对于患有常见肩部疾病的患者，PRP注射比其他治疗方法能提供更好的疼痛缓解和功能结局。PRP注射比其他干预措施更有能力改善与肩部相关的生活质量。
