Zhou Qinxin, Chen Jixin, Yu Weijie, Cao Dongdong, Ye Yuntian, Shen Jianzeng
Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, No. 641, Renmin Middle Road, Yuecheng District, Shaoxing City, 312000, Zhejiang Province, China.
Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China.
Clin Rheumatol. 2025 Feb;44(2):547-571. doi: 10.1007/s10067-024-07264-0. Epub 2024 Dec 30.
This study is to summarize and evaluate the available evidence for the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) for knee osteoarthritis (KOA). Eight databases were searched from inception to September 15, 2024. All systematic reviews (SRs)/meta-analyses (MAs) treated with PRP versus HA for KOA were collected. Literature screening and data extraction were independently performed by two reviewers. The methodological quality, reporting quality, risk of bias, evidence quality, and evidence overlap rate of the included studies were evaluated by using AMSTAR 2, PRISMA 2020, ROBIS, GRADE, and GROOVE systems. Seventeen SRs were included. The results showed that the effectiveness and safety of PRP in the treatment of KOA may be superior to HA. The methodological quality of all 17 documents was extremely low quality. Sixteen of them had poor reporting quality, and there were relatively serious information deficiencies. All SRs were determined to be at high risk. Among the 221 outcome indicators, there were two medium-quality evidences, 30 low-quality evidences, and 189 extremely low-quality evidences. It was found that there was a very high overlap among the included articles. Currently, the quality of SRs on the treatment of KOA with PRP versus HA is relatively low. Future authors of SRs should adhere to quality assessment tool criteria, expand sample sizes to reduce overlap, and evaluate the quality of evidence for merged study results, in order to provide more reliable and rigorous evidence-based support for clinical practice.
本研究旨在总结和评估富血小板血浆（PRP）和透明质酸（HA）治疗膝关节骨关节炎（KOA）的现有证据。检索了8个数据库，检索时间从建库至2024年9月15日。收集了所有比较PRP与HA治疗KOA的系统评价（SRs）/荟萃分析（MAs）。由两名 reviewers 独立进行文献筛选和数据提取。采用AMSTAR 2、PRISMA 2020、ROBIS、GRADE和GROOVE系统对纳入研究的方法学质量、报告质量、偏倚风险、证据质量和证据重叠率进行评估。纳入了17项SRs。结果表明，PRP治疗KOA的有效性和安全性可能优于HA。所有17篇文献的方法学质量极低。其中16篇报告质量较差，存在较为严重的信息缺陷。所有SRs均被判定为高风险。在221个结局指标中，有2个中等质量证据、30个低质量证据和189个极低质量证据。发现纳入的文章之间存在非常高的重叠。目前，关于PRP与HA治疗KOA的SRs质量相对较低。未来SRs的作者应遵循质量评估工具标准，扩大样本量以减少重叠，并评估合并研究结果的证据质量，以便为临床实践提供更可靠、更严谨的循证支持。
