Yin Shi, Zhao Xiyan, Li Tian, Li Xingxuan, Xie Zongjun, Tang Hao, Wang Yi, Jia Zhiwei, Wen Tianlin, Wu Yaohong
Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China.
Ther Clin Risk Manag. 2024 Dec 27;20:919-927. doi: 10.2147/TCRM.S487948. eCollection 2024.
The debate over the effectiveness of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in treating hip osteoarthritis (HOA) continues. This cross-sectional analysis of overlapping systematic reviews aims to evaluate the efficacy of intra-articular PRP compared to HA for HOA treatment. The goal is to guide decision-makers in selecting the most reliable systematic reviews and to provide treatment recommendations based on the best available evidence.
We conducted comprehensive searches of PubMed, EMBASE, and Cochrane Library databases to identify systematic reviews comparing intra-articular PRP and HA for HOA treatment. The methodological quality of these reviews was assessed, and relevant data were extracted. The Jadad algorithm was applied to determine which reviews provided the most robust evidence.
Five systematic reviews were included, all categorized as Level-II evidence. The Assessment of Multiple Systematic Reviews scores ranged from 4 to 9, with a median score of 8. A high-quality systematic review was chosen according to the Jadad algorithm. It is suggested that there were no significant differences observed in the improvement of any short-term outcome scores (mean follow-up of 12.2 months for PRP, 11.9 months for HA), including the Western Ontario and McMaster Universities Osteoarthritis Index, the Visual Analog Scale for pain, and the Harris Hip Score, from pre-injection to post-injection between the groups.
There is inconsistency among the conclusions of the overlapping systematic reviews comparing intra-articular PRP and HA for HOA treatment. The best evidence indicates that PRP and HA injections yield similar short-term clinical benefits for patients with HOA. Further studies with larger sample sizes and longer follow-up periods are needed to provide more definitive conclusions.
关于富血小板血浆（PRP）与透明质酸（HA）治疗髋骨关节炎（HOA）有效性的争论仍在继续。这项对重叠系统评价的横断面分析旨在评估关节内注射PRP与HA治疗HOA的疗效。目标是指导决策者选择最可靠的系统评价，并基于现有最佳证据提供治疗建议。
我们对PubMed、EMBASE和Cochrane图书馆数据库进行了全面检索，以识别比较关节内注射PRP和HA治疗HOA的系统评价。评估了这些评价的方法学质量，并提取了相关数据。应用Jadad算法确定哪些评价提供了最有力的证据。
纳入了五项系统评价，均归类为二级证据。多项系统评价的评分范围为4至9分，中位数为8分。根据Jadad算法选择了一项高质量的系统评价。结果表明，两组之间从注射前到注射后，在任何短期结局评分（PRP组平均随访12.2个月，HA组平均随访11.9个月）的改善方面均未观察到显著差异，包括西安大略和麦克马斯特大学骨关节炎指数、视觉模拟疼痛量表和Harris髋关节评分。
在比较关节内注射PRP和HA治疗HOA的重叠系统评价的结论中存在不一致。最佳证据表明，PRP和HA注射对HOA患者产生相似的短期临床益处。需要进行更大样本量和更长随访期的进一步研究，以提供更明确的结论。
