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The efficacy of platelet-rich plasma in ankle disease: a systematic review and meta-analysis.

作者信息

Ding Qixin, Wang Xu, Liu Yurong, Li Yuefang, Zhang Di, Wang Heling, Ma Shenhong, Han Qiaohua, Zhuang Weisheng

机构信息

School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China.

Hunan Normal University, Changshao, China.

出版信息

J Orthop Surg Res. 2024 Dec 31;19(1):895. doi: 10.1186/s13018-024-05420-5.


DOI:10.1186/s13018-024-05420-5
PMID:39741342
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11689593/
Abstract

OBJECTIVE: Ankle osteoarthritis is a debilitating condition that significantly impairs patients' quality of life. Platelet-rich plasma has emerged as a novel cellular therapy in clinical practice. This study evaluates the clinical efficacy of platelet-rich plasma (PRP) after intervention in ankle disorders, so as to provide strong evidence in support of clinical treatment. METHODS: A comprehensive and systematic search of PubMed, the Cochrane Library, Embase and web of science databases was performed, and studies that met the requirements according to the inclusion criteria were analyzed using Review Manager and STATA version 14.0. Quality assessment was performed using the Cochrane Collaboration Risk of Bias 2.0 tool. The outcome indicators were the American Orthopaedic Foot and Ankle Society Rating Scale (AOFAS) and Visual Analog Scale (VAS) scores used to evaluate the efficacy of platelet-rich plasma. RESULTS: A total of 10 studies met the inclusion criteria. Regarding the AOFAS score, a meta-analysis that included five randomized controlled trials (each study extracted the score results at the last follow-up time) showed no statistically significant differences between the platelet-rich plasma intervention group and the control group, and there was a great deal of heterogeneity in the results, with subgroup analyses based on disease type. (Mean Difference = 4.14, 95% CI=-0.60-8.87, p = 0.09, I = 86%). Subgroup analysis showed a more significant effect in patients with talar cartilage injuries (Mean Difference = 8.66, 95%CI = 6.61-10.71, p < 0.00001, I = 0%). And the treatment effect of PRP remained effective in long-term follow-up (Mean Difference = 7.83, 95% CI = 5.57-10.09, p = 0.46, I = 0%). For VAS scores, PRP relieved patients' pain (Standardized Mean Difference=-0.62, 95%CI=-1.13-0.10, p = 0.02, I = 77%) but showed a greater advantage in patients with cartilage injuries of the talus (Standardized Mean Difference=-1.24, 95%CI=-1.68-0.81, p < 0.00001, I = 0%). Subgroup analyses according to different disease types and different follow-up times showed that PRP had significant efficacy in talar cartilage injuries in both the short and long term. A meta-analysis of single-arm studies showed that PRP was helpful in improving patients' pain before and after the intervention (Standardized Mean Difference = -1.76, 95% CI = -2.85 to -0.67, p = 0.002, I^2 = 87%).However, the high level of heterogeneity may be due to the large differences between the inclusion criteria of the single-arm studies. CONCLUSION: More clinical studies are needed to further confirm the efficacy of platelet-rich plasma in ankle disorders, and the current study only suggests that platelet-rich plasma may be more effective in talus cartilage injuries than in other types of ankle disorders.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/4a643b1f7f9d/13018_2024_5420_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/345f1da1c130/13018_2024_5420_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/261dc9aaef48/13018_2024_5420_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/475090fe2688/13018_2024_5420_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/079f5e32eee6/13018_2024_5420_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/1572329c2d51/13018_2024_5420_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/f7a109c46700/13018_2024_5420_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/4a643b1f7f9d/13018_2024_5420_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/345f1da1c130/13018_2024_5420_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/261dc9aaef48/13018_2024_5420_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/475090fe2688/13018_2024_5420_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/079f5e32eee6/13018_2024_5420_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/1572329c2d51/13018_2024_5420_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/f7a109c46700/13018_2024_5420_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/710e/11689593/4a643b1f7f9d/13018_2024_5420_Fig7_HTML.jpg

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The efficacy of platelet-rich plasma in ankle disease: a systematic review and meta-analysis.

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引用本文的文献

[1]
Comparative efficacy of different doses of platelet-rich plasma injection in the treatment of knee osteoarthritis: a systematic review and network meta-analysis.

J Orthop Surg Res. 2025-3-1

[2]
Special screw corridors and imaging in pelvic ring trauma.

Arch Orthop Trauma Surg. 2025-1-4

本文引用的文献

[1]
The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies.

JBI Evid Synth. 2024-3-1

[2]
Epidemiology of osteoarthritis: literature update 2022-2023.

Curr Opin Rheumatol. 2024-3-1

[3]
Results of Anatomical Arthroscopic Repair of Anterior Talofibular Ligament in Chronic Lateral Ankle Instability Patients.

Foot Ankle Int. 2023-12

[4]
Current Non-surgical Management of Knee Osteoarthritis.

Cureus. 2023-6-26

[5]
Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis.

Am J Sports Med. 2023-8

[6]
Safety and efficacy of intra-articular injection of platelet-rich plasma for the treatment of ankle osteoarthritis: a systematic review and meta-analysis.

Int Orthop. 2023-8

[7]
An open-source OpenSim® ankle-foot musculoskeletal model for assessment of strains and forces in dense connective tissues.

Comput Methods Programs Biomed. 2022-9

[8]
Platelet-Rich Plasma as an Orthobiologic: Clinically Relevant Considerations.

Vet Clin North Am Small Anim Pract. 2022-7

[9]
Autologous Platelet-Rich Plasma Applications in Chronic Pain Medicine: Establishing a Framework for Future Research - A Narrative Review.

Pain Physician. 2022-1

[10]
[Conservative treatment options for arthritis of the ankle : What is possible, what is effective?].

Unfallchirurg. 2022-3

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