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富血小板血浆与皮质类固醇注射治疗慢性肌腱病:一项系统评价和荟萃分析。

Platelet-Rich Plasma Versus Corticosteroid Injections for Chronic Tendinopathies: A Systematic Review and Meta-Analysis.

作者信息

Elnewishy Ahmed, Elsenosy Abdelfatah M, Teama Hagar, Symeon Naoum, Hamada Ahmed

机构信息

Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, GBR.

Trauma and Orthopaedics, University Hospitals Dorset, Poole, GBR.

出版信息

Cureus. 2024 Dec 20;16(12):e76051. doi: 10.7759/cureus.76051. eCollection 2024 Dec.

Abstract

Chronic tendinopathy is a degenerative condition characterized by persistent pain, functional limitations, and tendon thickening, often resulting from repetitive overuse or failed tendon healing. Left untreated, it can progress to tendon rupture, prolonged disability, and impaired quality of life. Management typically includes conservative therapies, such as physical therapy, corticosteroid (CS) injections for short-term relief, and platelet-rich plasma (PRP) as a regenerative therapy with potential long-term benefits. This systematic review and meta-analysis evaluates and compares the effectiveness of PRP and CS injections for chronic tendinopathies regarding pain reduction, functional improvement, and long-term outcomes. A structured search of PubMed, Scopus, Google Scholar, and the Cochrane Library identified randomized controlled trials (RCTs) and comparative studies. Primary outcomes included pain reduction and functional improvement while secondary outcomes assessed heterogeneity and publication bias. PRP and CS injections demonstrated no significant difference in short-term pain reduction. Functional outcomes were comparable in the short term but showed a trend favoring PRP at longer follow-up periods. PRP exhibited a slight advantage in long-term functional recovery, though the results were not statistically significant. Substantial heterogeneity across studies highlights the need for standardized protocols and larger trials to confirm these findings and optimize treatment strategies.

摘要

慢性肌腱病是一种退行性疾病,其特征为持续疼痛、功能受限和肌腱增厚,通常由重复性过度使用或肌腱愈合失败引起。若不治疗,可能会发展为肌腱断裂、长期残疾并损害生活质量。治疗通常包括保守疗法,如物理治疗、用于短期缓解的皮质类固醇(CS)注射,以及作为具有潜在长期益处的再生疗法的富血小板血浆(PRP)。本系统评价和荟萃分析评估并比较了PRP和CS注射治疗慢性肌腱病在减轻疼痛、改善功能和长期疗效方面的有效性。对PubMed、Scopus、谷歌学术和考克兰图书馆进行结构化检索,确定了随机对照试验(RCT)和比较研究。主要结局包括疼痛减轻和功能改善,次要结局评估异质性和发表偏倚。PRP和CS注射在短期疼痛减轻方面无显著差异。短期功能结局相当,但在更长的随访期显示出有利于PRP的趋势。PRP在长期功能恢复方面表现出轻微优势,尽管结果无统计学意义。各研究间存在显著异质性,这凸显了需要标准化方案和更大规模试验来证实这些发现并优化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8653/11695647/989ad181d981/cureus-0016-00000076051-i01.jpg

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