[1]孙红,苏蒙召,胥泽玺,等.富血小板血浆与透明质酸治疗膝关节骨关节炎的meta分析[J].中华老年骨科与康复电子杂志,2022,(01):44-53.[doi:10.3877/cma.j.issn.2096-0263.2022.01.008]
 Sun Hong,Su Mengzhao,Xu Zexi,et al.Platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis: A meta-analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(01):44-53.[doi:10.3877/cma.j.issn.2096-0263.2022.01.008]
点击复制

富血小板血浆与透明质酸治疗膝关节骨关节炎的meta分析()
分享到:

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年01期
页码:
44-53
栏目:
Meta分析
出版日期:
2022-02-05

文章信息/Info

Title:
Platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis: A meta-analysis
作者:
孙红1苏蒙召2胥泽玺2彭国璇3邓进3宁旭1杨华1
550004 贵阳,贵州医科大学附属医院骨科1;550004 贵阳,贵州医科大学临床医学院2;550004 贵阳,贵州医科大学附属医院急诊医学科3
Author(s):
Sun Hong1 Su Mengzhao2 Xu Zexi2 Peng Guoxuan3 Deng Jin3 Ning Xu1 Yang Hua1.
1Department of Orthopaedics, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China; 2Department of Clinical Medical college, Guizhou Medical University, Guiyang 550004, China; 3Department of Emergence Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
关键词:
骨关节炎 注射关节内 富血小板血浆 透明质酸 meta分析
Keywords:
Osteoarthritis knee Injection intra?articular Platelet-rich plasma Hyaluronic acid Meta-analysis
DOI:
10.3877/cma.j.issn.2096-0263.2022.01.008
文献标志码:
A
摘要:
目的 本研究旨在探讨富血小板血浆(PRP)与透明质酸(HA)在治疗膝关节骨关节炎(KOA)的疗效差异。方法 系统检索在线数据库,包括PubMed、Embase、Ovid、Cochrane Library,收集探讨PRP与HA治疗KOA的随机对照研究(RCTs)。主要评价指标为西安大略与麦克马斯特大学骨关节炎指数(WOMAC)疼痛和功能评分。次要评价指标为WOMAC总评分、WOMAC僵硬度评分、国际膝关节文献委员会膝关节评估表(IKDC)评分、疼痛视觉模拟(VAS)评分、EuroQol(EQ)-VAS评分、国际膝关节文献委员会膝关节评估表(KOOS)评分、Lequesne指数和不良事件。采用Review Manager 5.3软件进行数据分析。结果 本研究纳入19篇随机对照研究,共包含1 818膝。研究结果表明,PRP组患者WOMAC疼痛评分和VAS评分6个月和12个月随访时较HA组患者降低。PRP组患者EQ-VAS评分12个月随访时低于接受HA组患者。此外, 1个月、3个月、6个月和12个月随访时,PRP组患者WOMAC功能评分高于HA组患者。两组WOMAC总评分在6个月和12个月随访时差异明显。3个月和6个月随访时,PRP组患者IKDC评分优于HA组患者。两组之间的Lequesne指数、KOOS评分和不良事件发生率差异无统计学意义。结论 对于膝关节骨关节炎治疗而言,PRP在早期功能康复方面似乎比HA更有效,而在远期疼痛缓解和功能康复方面前者明显优于后者。此外,与HA注射相比,PRP注射不会增加不良事件发生的风险。
Abstract:
Objective This study aimed to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA) injection for the treatment of patients diagnosed with knee osteoarthritis (KOA). Methods Online databases including PubMed, Embase, Ovid and, Cochrane Library, CNKI and Wanfang database were systematically searched to collect the random controlled trials (RCT) comparing the clinical efficacy between PRP and HA in the treatment of KOA. The primary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function score. Secondary outcomes were WOMAC total score, WOMAC stiffness score, International Knee Documentation Committee (IKDC) score, visual analog scale (VAS) score, EuroQol (EQ)-VAS score, Knee and Osteoarthritis Outcome System (KOOS) score, Lequesne Index score and adverse events. The pooled results were calculated by Review Manager 5.3. Results A total of 19 RCTs were enrolled in present study. The pooled results demonstrated that PRP injection was more effective than HA injection in pain relief at 6-month and 12-month of follow-up evaluated by WOMAC pain score and VAS score. EQ-VAS score in the patients treated with PRP injection was lower than that in patients with HA injection at 12-month. Moreover, the patients with PRP injection had a better function recovery than those with HA injection at 1 month, 3-month, 6-month and 12-month after surgery, as evaluated by WOMAC function score. WOMAC total score showed significant difference at 6-months and 12-month after surgery. The IKDC score indicated PRP injection was significantly more effective than HA injection at 3-month and 6-month after surgery. However, the Lequesne Index score, KOOS score and adverse events didn’t show any significant difference between the groups. Conclusions Intra-articular PRP injection appeared to be more efficacy than HA injection for the treatment of KOA in terms of short-term functional recovery. Moreover, PRP injection was superior to HA injection in terms of long-term pain relief and function improvement. In addition, PRP injection didn’t increase the risk of adverse events compared to HA injection.

相似文献/References:

[1]周磊 曲铁兵 林源 潘江 王志为 任世祥 陈彤 温亮 张博 马德思.腓骨近端截骨术治疗膝关节骨关节炎的疗效评价[J].中华老年骨科与康复电子杂志,2016,(01):16.[doi:10.3877/cma.j.issn.2096-0263.2016.01.004]
 Zhou Lei,Qu Tiebing,Lin Yuan,et al.Evaluation of proximal fibula osteotomy for treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):16.[doi:10.3877/cma.j.issn.2096-0263.2016.01.004]
[2]白玉,王爱国,骆晓飞.腓骨近端截骨术治疗内侧间室性膝关节骨关节炎的疗效分析与机制探讨[J].中华老年骨科与康复电子杂志,2016,(03):161.[doi:10.3877/cma.j.issn.2096-0263.2016.03.007]
 Bai Yu,Wang Aiguo,Luo Xiaofei.The effect and mechanism of proximal fibular osteotomy in treating medial compartment osteoarthritis of the knee[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):161.[doi:10.3877/cma.j.issn.2096-0263.2016.03.007]
[3]李玉龙,翁习生,董玉雷.老年全膝关节置换术围手术期并发症影响因素的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
 Li Yulong,Weng Xisheng,Dong Yulei.Research progress of influence factors concerning perioperative complications of total knee arthroplasty in aged patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
[4]尹正录,孟兆祥,林舜艳,等.MOTOmed智能运动训练结合神经肌肉本体感觉促进技术对全膝关节置换术后功能恢复的影响[J].中华老年骨科与康复电子杂志,2017,(01):50.[doi:10.3877/cma.j.issn.2096-0263.2017.01.010]
 Yin Zhenglu,Meng Zhaoxiang,Lin Shunyan,et al.Effects of MOTOmed intelligent motor training and proprioceptive neuromuscular facilitation on postoperative function recovery in total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):50.[doi:10.3877/cma.j.issn.2096-0263.2017.01.010]
[5]陈后煌,邵翔,叶蕻芝,等.独活寄生汤对脂多糖诱导的大鼠软骨细胞炎症模型 IL-1β、TNF-α表达的影响[J].中华老年骨科与康复电子杂志,2017,(02):77.[doi:10.3877/cma.j.issn.2096-0263.2017.02.003]
 Chen Houhuang,Shao Xiang,Ye Hongzhi,et al.Effects of DuhuoJisheng decoction on the expression of IL-1β and TNF-α of inflammatory Chondrocytes[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):77.[doi:10.3877/cma.j.issn.2096-0263.2017.02.003]
[6]孙鹏,艾登超,马骏,等.腓骨近端截骨术治疗内侧间室型膝关节骨关节炎的有效率及并发症率的 Meta分析[J].中华老年骨科与康复电子杂志,2017,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2017.03.009]
 un Peng,Ai Dengchao,Ma Jun,et al.The efficacy and complication rate of proximal fibula osteotomy in the treatment of knee osteoarthritis with medial compartment strteosis--A Meta analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):177.[doi:10.3877/cma.j.issn.2096-0263.2017.03.009]
[7]曲文庆,张俊勇,董圣杰,等.术前合并症对老年晚期骨性踝关节炎关节融合术疗效影响[J].中华老年骨科与康复电子杂志,2017,(05):290.[doi:10.3877/cma.j.issn.2096-0263.2017.05.008]
 Qu Wenqing,Zhang Junyong,Dong Shengjie,et al.Effects of preoperative complications on osteoarthritis of ankle arthroarthritis in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):290.[doi:10.3877/cma.j.issn.2096-0263.2017.05.008]
[8]扈鑫,高石军,董江涛,等.中老年全膝关节置换术后下肢深静脉血栓形成的解剖部位分布特点[J].中华老年骨科与康复电子杂志,2017,(05):296.[doi:10.3877/cma.j.issn.2096-0263.2017.05.009]
 Hu Xin,Gao Shijun,Dong Jiangtao,et al.The anatomical distribution of lower extremity deep vein thrombosis of middle-aged, and older patients after total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):296.[doi:10.3877/cma.j.issn.2096-0263.2017.05.009]
[9]白伟侠,牛映祯,马红瑞,等.氨甲环酸在初次膝关节置换中的应用研究[J].中华老年骨科与康复电子杂志,2017,(06):362.[doi:10.3877/cma.j.issn.2096-0263.2017.06.009]
 Bai Weixia,Niu Yingzhen,Ma Hongrui,et al.Application of ammoniacal acid in primary total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):362.[doi:10.3877/cma.j.issn.2096-0263.2017.06.009]
[10]黄子达,张子杰,李文波,等.多模式预防措施对老年关节置换术后静脉血栓栓塞症发生及转归的影响[J].中华老年骨科与康复电子杂志,2018,(02):80.[doi:10.3877/cma.j.issn.2096-0263.2018.02.004]
 Huang Zida,Zhang Zijie,Li Wenbo,et al.Incidence and outcome of postoperative venous thromboembolism in elderly patients underwent knee or hip arthroplasty with multimodal thromboprophylaxis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(01):80.[doi:10.3877/cma.j.issn.2096-0263.2018.02.004]
[11]李涛 史占军.膝关节骨关节炎的非置换手术[J].中华老年骨科与康复电子杂志,2016,(01):1.[doi:10.3877/cma.j.issn.2096-0263.2016.01.001]
[12]徐彬 马俊 聂涌 黄泽宇 谭震 裴福兴.腓骨近端截骨术治疗膝关节骨关节炎的早期临床疗效研究[J].中华老年骨科与康复电子杂志,2016,(01):11.[doi:10.3877/cma.j.issn.2096-0263.2016.01.003]
 Xu Bin,MaJun,Nie Yong,et al.Early clinical effect of proximal fibular osteotomy on the treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):11.[doi:10.3877/cma.j.issn.2096-0263.2016.01.003]
[13]王英明 孔荣 禹德万 朱晨 官建中 周建生.腓骨近端截骨联合关节镜下膝关节清理治疗膝关节内侧间室骨关节炎的临床疗效[J].中华老年骨科与康复电子杂志,2016,(01):21.[doi:10.3877/cma.j.issn.2096-0263.2016.01.005]
 Wang Yingming,Kong Rong,Yu Dewan,et al.Effect of proximal fibular osteotomy combined with arthroscopic debridement on medial compartment knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):21.[doi:10.3877/cma.j.issn.2096-0263.2016.01.005]
[14]徐明 付志厚 孙海宁 曲新涛 于秀淳.腓骨近端截骨与单髁关节置换治疗膝关节内侧单间室骨关节炎的疗效比较[J].中华老年骨科与康复电子杂志,2016,(01):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
 Xu Ming,Fu Zhihou,Sun Haining,et al.Comparison study of proximal fibular osteotomy versus unicompartmental knee arthroplasty for medialcompartment osteoarthritis of the knee[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
[15]郑艮强 吴斗 赵恩哲 田亮 郜振武 郑上团 刘强.膝关节周围截骨术对膝关节骨关节炎伴内翻畸形的治疗策略[J].中华老年骨科与康复电子杂志,2016,(01):44.[doi:10.3877/cma.j.issn.2096-0263.2016.01.009]
[16]孙佳冰 付春江 邹吉龙 陈洪均 王旭明 张鹏 毕郑刚.膝关节软骨剥脱分期对腓骨近端截骨治疗膝关节骨关节炎的指导意义[J].中华老年骨科与康复电子杂志,2016,(01):50.[doi:10.3877/cma.j.issn.2096-0263.2016.01.010]
[17]张寿 曹亮.不均匀沉降理论在膝关节骨关节炎治疗中的应用[J].中华老年骨科与康复电子杂志,2016,(01):58.[doi:10.3877/cma.j.issn.2096-0263.2016.01.012]
[18]赵娇娇,傅照华.短波疗法治疗膝关节骨关节炎的研究进展[J].中华老年骨科与康复电子杂志,2016,(02):125.[doi:10.3877/cma.j.issn.2096-0263.2016.02.012]
 Zhao Jiaojiao,Fu Zhaohua..The research progress on the short wave therapy in the treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):125.[doi:10.3877/cma.j.issn.2096-0263.2016.02.012]
[19]侯永新,程伟强,张民,等.腓骨近端截骨与关节镜清理治疗内翻型膝关节骨关节炎的疗效比较[J].中华老年骨科与康复电子杂志,2016,(03):166.[doi:10.3877/cma.j.issn.2096-0263.2016.03.008]
 Hou Yongxin,Cheng Weiqiang,Zhang Min,et al.Comparison on the efficacy of proximal fibular osteotomy and arthroscopic debridement in treatment of varus knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):166.[doi:10.3877/cma.j.issn.2096-0263.2016.03.008]
[20]李雪靖,张雪松,刘思思,等.腓骨近端截骨联合关节镜下清理治疗内翻型膝关节骨关节炎的成本效果分析[J].中华老年骨科与康复电子杂志,2016,(04):222.[doi:10.3877/cma.j.issn.2096-0263.2016.04.006]
 Li Xuejing,Zhang Xuesong,Liu Sisi,et al.Cost-effectiveness analysis of proximal fibular osteotomy combined with arthroscopy debridement for medial compartment knee ostoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):222.[doi:10.3877/cma.j.issn.2096-0263.2016.04.006]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(NO. 81772403;NO. 81660317);贵州省科技厅基础研究计划(黔科合基础-ZK[2021]一般391)
更新日期/Last Update: 2022-04-25