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富血小板血浆与皮质类固醇注射治疗肩袖损伤的疗效比较:一项系统评价与Meta分析

Comparative Efficacy of Platelet-Rich Plasma and Corticosteroid Injections for Rotator Cuff Injury Management: A Systematic Review and Meta-Analysis.

作者信息

Alshahir Nwaf, Alsanawi Hisham A, Alanezi Mishari, Ekram Jori, Aldkhyyal Mohammed, Al Sherieqi Mohammed, Alrajhi Samar, Altorki Mohammed, Alhawas Sultan, Fallatah Emtinan, Mahdi Abdulaziz, Alassaf Talal, Abdulkareem Hawraa

机构信息

College Of Medicine King Saud University.

Department of Orthopedic Surgery, College of Medicine King Saud University.

出版信息

Orthop Rev (Pavia). 2025 Sep 6;17:143581. doi: 10.52965/001c.143581. eCollection 2025.

Abstract

BACKGROUND

Rotator cuff injuries are very common in the athletic population and both corticosteroid injections and platelets enriched plasma (PRP) are common management options used in clinical practice yet there aren't any recent systematic reviews that compare between the two, thus, this study aims to provide a high-quality systematic review of the clinical trials and the experimentation found in the literature as of yet to guide practitioners in choosing between these two management options.

METHODS

This systematic review was conducted in accordance to PRISMA guidelines and was registered in PROSPERO (CRD4202461663). A comprehensive search was done in the following databases MEDLINE, Web of Science, Google Scholar. The included studies were comparing Platelet Rich-Plasma with Corticosteroid injections for rotator cuff injuries for Adult patients that struggled with the injury for more than three months. The measurements that were used to determine the outcomes were: pain (VAS score) and functional scores (e.g Constant-Murley, ASES, SST).

RESULTS

Pain reduction (VAS score) PRP showed to be somewhat better in the short term but had similar scores to corticosteroids on the remaining time marks, with the difference between them being insignificant, also, PRP showed to be more effective than Corticosteroids in improving function, particularly as time went on, the difference became more apparent (at 3-6 weeks, the mean difference was -3.97, after 24 weeks, it became 9.85 Constant-Murley).

CONCLUSION

When comparing between corticosteroids and PRP, there is no significant difference between them regarding pain reduction, yet, PRP has proven its effectiveness over the long-term for functional improvement, and which means that it could see more clinical use provided that it is cost-effective, yet more research is required to reach a final judgment and thorough evaluation due to the heterogeneity found in the studies.

摘要

背景

肩袖损伤在运动员群体中非常常见,皮质类固醇注射和富血小板血浆(PRP)都是临床实践中常用的治疗选择,但目前尚无近期的系统评价对两者进行比较。因此,本研究旨在对文献中已有的临床试验和实验进行高质量的系统评价,以指导从业者在这两种治疗选择之间做出抉择。

方法

本系统评价按照PRISMA指南进行,并在PROSPERO(CRD4202461663)注册。在以下数据库中进行了全面检索:MEDLINE、科学网、谷歌学术。纳入的研究比较了富血小板血浆与皮质类固醇注射治疗肩袖损伤的效果,研究对象为成年患者,这些患者肩袖损伤超过三个月。用于确定结果的测量指标包括:疼痛(视觉模拟评分法[VAS]评分)和功能评分(如Constant-Murley评分、美国肩肘外科医师学会[ASES]评分、简单肩部测试[SST]评分)。

结果

在疼痛减轻方面(VAS评分),PRP在短期内表现略好,但在其余时间点与皮质类固醇的评分相似,两者差异不显著。此外,PRP在改善功能方面比皮质类固醇更有效,尤其是随着时间的推移,差异变得更加明显(在3至6周时,平均差异为-3.97,24周后变为9.85[Constant-Murley评分])。

结论

在比较皮质类固醇和PRP时,两者在减轻疼痛方面没有显著差异,但PRP已证明其在长期功能改善方面的有效性,这意味着如果具有成本效益,它可能会得到更多的临床应用。然而,由于研究中发现的异质性,需要更多的研究才能得出最终结论并进行全面评估。

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本文引用的文献

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Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.系统评价与Meta分析的首选报告项目:PRISMA声明。
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