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富血小板血浆注射治疗部分厚度肩袖撕裂的非手术治疗:系统评价和荟萃分析。

Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis.

机构信息

Department of Cardiology, Wuhan Fourth Hospital, Wuhan, China.

Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Rehabil Med. 2022 Sep 16;54:jrm00312. doi: 10.2340/jrm.v54.1434.

Abstract

OBJECTIVE

Partial-thickness rotator cuff tears have a high prevalence in older people. Treatment for such tears remains controversial. Platelet-rich plasma has recently attracted attention for treating partial-thickness rotator cuff tears, due to its regenerative characteristics. However, the results of application of platelet-rich plasma in non-operative treatments are unclear. The aim of this review is to evaluate the effects on shoulder function improvement and pain relief of platelet-rich plasma injection in partial-thickness rotator cuff tears, at different follow-up times (3-6 weeks, 8-12 weeks, and more than 24 weeks after treatment) compared with placebo or corticosteroids.

DESIGN

A systematic review and meta-analysis.

METHODS

Several databases, including PubMed, EMBASE, and Cochrane, were searched. Eleven studies met the inclusion criteria for the meta-analysis. The quality of research was evaluated using the Cochrane risk-of-bias tool. The effectiveness of platelet-rich plasma was calculated as the difference between baseline measurements and post-injection outcomes. The standardized mean difference was used to compare different outcome scales or questionnaire measurements. Statistical analysis was performed using Stata 15.0.

RESULTS

The analysis included 11 studies, with a total of 641 patients (318 treated with platelet-rich plasma and 323 controls). Compared with placebo, platelet-rich plasma exhibited significantly better effects on shoulder function improvement and pain relief at all 3 follow-up times. Compared with other conservative treatments, platelet-rich plasma exhibited significantly better effects on shoulder function and pain relief at 8-12 weeks and at more than 24 weeks after treatment.

CONCLUSION

This review showed positive effects on shoulder function improvement and pain relief of the use of platelet-rich plasma in treating partial-thickness rotator cuff tears, especially in relatively late stages of follow-up (more than 8 weeks) after treatment.

摘要

目的

部分厚度肩袖撕裂在老年人中较为常见。对于此类撕裂的治疗仍存在争议。富血小板血浆因其具有再生特性,最近受到关注,可用于治疗部分厚度肩袖撕裂。然而,富血小板血浆在非手术治疗中的应用效果尚不清楚。本综述旨在评估与安慰剂或皮质类固醇相比,富血小板血浆注射治疗部分厚度肩袖撕裂在不同随访时间(治疗后 3-6 周、8-12 周和 24 周以上)对改善肩部功能和缓解疼痛的效果。

设计

系统回顾和荟萃分析。

方法

检索了包括 PubMed、EMBASE 和 Cochrane 在内的多个数据库。11 项研究符合荟萃分析的纳入标准。使用 Cochrane 偏倚风险工具评估研究质量。富血小板血浆的有效性通过基线测量值与注射后结果之间的差值来计算。使用标准化均数差来比较不同的结果量表或问卷测量值。使用 Stata 15.0 进行统计分析。

结果

该分析纳入了 11 项研究,共 641 名患者(318 名接受富血小板血浆治疗,323 名接受安慰剂治疗)。与安慰剂相比,富血小板血浆在所有 3 个随访时间点在改善肩部功能和缓解疼痛方面均具有显著更好的效果。与其他保守治疗相比,富血小板血浆在治疗后 8-12 周和 24 周以上时在改善肩部功能和缓解疼痛方面具有显著更好的效果。

结论

本综述表明,富血小板血浆治疗部分厚度肩袖撕裂在改善肩部功能和缓解疼痛方面具有积极的效果,尤其是在治疗后 8 周以上的随访后期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064c/9495266/23d1b5457207/JRM-54-1434-g001.jpg

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