1Department Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
1Department Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan; 3School of Rehabilitation, Capital Medical University, Beijing, China.
Georgian Med News. 2024 Apr(349):169-182.
The aim of this meta-analysis is to evaluate the clinical effectiveness of intra-articular injections of platelet-rich plasma (PRP) versus corticosteroid (CS) in treating knee osteoarthritis (KOA). A comprehensive search of the PubMed, Embase, and Web of Science databases was conducted for literature on intra-articular PRP and CS injections for the treatment of knee osteoarthritis, with the search period extending to December 2023. The risk of bias was assessed using the Cochrane Risk of Bias tool, and statistical analysis was subsequently carried out using Review Manager 5.4.1 software. The efficacy of PRP versus CS injections across various studies was compared based on the weighted mean difference and 95% confidence interval for scores from the Visual Analogue Scale (VAS), Knee Osteoarthritis Outcome Score (KOOS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In our analysis, we incorporated twelve studies encompassing a total of 801 joints, of which 404 were in the PRP group and 397 in the CS group. PRP group was significantly reduced the VAS score than CS group in 3-month (P=0.003), 6-month (P=0.007) and 9-month (P<0.00001); PRP group was significantly reduced the WOMAC total score compared to CS group in 1-month (P=0.01), 6-month (P=0.003), 9-month (P=0.005) and 12-month (P<0.00001); In 3-month and 6-month, PRP group were significantly increased the KOOS pain relief score (3-month: P=0.002, 6-month: P<0.00001), the KOOS activities of daily living scores (3-month: P<0.00001, 6-month: P<0.00001) and the KOOS quality of life score (3-month: P=0.003, 6-month: P<0.00001) compared to CS group; PRP group also were significantly increased the KOOS sports score in 3-month compared to CS group (P=0.04). The leukocyte-poor PRP (LP-PRP) group was significantly reduced the VAS score compared to CS group (P=0.04). Recent findings indicate that intra-articular injections of PRP yield superior results in alleviating pain and enhancing functionality in individuals with knee osteoarthritis, as opposed to CS injections. During short-term follow-up, no significant difference was observed between knee injections of PRP and CS. However, the benefits of PRP injections primarily become apparent in the medium to long-term management of clinical symptoms, including pain relief, enhancing patients' quality of life, increasing activities of daily living, and improving sports capabilities.
本荟萃分析旨在评估关节内注射富含血小板的血浆（PRP）与皮质类固醇（CS）治疗膝骨关节炎（KOA）的临床效果。对 PubMed、Embase 和 Web of Science 数据库进行了全面检索，以获取关于关节内 PRP 和 CS 注射治疗膝骨关节炎的文献，检索时间延长至 2023 年 12 月。使用 Cochrane 偏倚风险工具评估偏倚风险，随后使用 Review Manager 5.4.1 软件进行统计分析。根据视觉模拟量表（VAS）、膝关节骨关节炎结果评分（KOOS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的评分，比较了 PRP 与 CS 注射在各项研究中的疗效。在我们的分析中，我们纳入了 12 项共 801 个关节的研究，其中 PRP 组 404 个，CS 组 397 个。PRP 组在 3 个月（P=0.003）、6 个月（P=0.007）和 9 个月（P<0.00001）时 VAS 评分显著低于 CS 组；PRP 组在 1 个月（P=0.01）、6 个月（P=0.003）、9 个月（P=0.005）和 12 个月（P<0.00001）时 WOMAC 总分显著低于 CS 组；在 3 个月和 6 个月时，PRP 组 KOOS 疼痛缓解评分（3 个月：P=0.002，6 个月：P<0.00001）、KOOS 日常生活活动评分（3 个月：P<0.00001，6 个月：P<0.00001）和 KOOS 生活质量评分（3 个月：P=0.003，6 个月：P<0.00001）显著高于 CS 组；PRP 组在 3 个月时 KOOS 运动评分也显著高于 CS 组（P=0.04）。白细胞减少的富血小板血浆（LP-PRP）组与 CS 组相比，VAS 评分显著降低（P=0.04）。最近的研究结果表明，与 CS 注射相比，关节内注射 PRP 可更有效地缓解膝关节骨关节炎患者的疼痛和增强其功能。在短期随访中，PRP 和 CS 膝关节注射之间没有观察到显著差异。然而，PRP 注射的益处主要在中、长期临床症状管理中显现，包括疼痛缓解、提高患者生活质量、增加日常生活活动能力和改善运动能力。
J Orthop Surg Res. 2020-9-11
Zotero 插件