Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis
Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis
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DOI：
10.1093/pm/pnz011
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发表时间：
2019-07-01
期刊：
影响因子：
3.1
通讯作者：
Liu, Jun
中科院分区：
文献类型：
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作者：
Han, Yanhong;Huang, Hetao;Liu, Jun
目的.本荟萃分析的目的是比较富血小板血浆（PRP）和透明质酸（HA）在膝关节骨关节炎（KOA）患者中的作用。方法.从每个数据库中检索了从建立日期到2018年4月比较PRP和HA在KOA患者中使用的随机对照试验（RCT）。结果测量为西安大略和麦克马斯特大学关节炎指数（WOMAC）、视觉模拟量表（VAS）、国际膝关节文献委员会和Lequesne指数评分和不良事件。使用Review Manager 5.3.5评价合并数据。结果我们的荟萃分析纳入了15项RCT（N = 1，314）。本荟萃分析表明，在6个月和12个月随访时，PRP注射比HA注射更有效地减轻了KOA患者的疼痛，通过WOMAC疼痛评分进行评价; VAS疼痛评分在12个月时显示出显著差异。此外，PRP组观察到更好的功能改善，如3个月、6个月和12个月时的WOMAC功能评分所示。此外，与HA注射相比，PRP注射未显示出不同的不良事件发生率。结论在长期疼痛缓解和功能改善方面，PRP注射可能比HA注射更有效地治疗KOA。最佳剂量，注射的时间间隔和频率，以及KOA不同阶段的理想治疗仍然是未来研究的关注领域。
Purpose. The purpose of this meta-analysis was to compare platelet-rich plasma (PRP) and hyaluronic acid (HA) in patients with knee osteoarthritis (KOA). Methods. Randomized controlled trials (RCTs) comparing the use of PRP and HA in KOA patients were retrieved from each database from the establishment date to April 2018. Outcome measurements were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), International Knee Documentation Committee, and Lequesne Index scores and adverse events. The pooled data were evaluated with Review Manager 5.3.5. Results. Fifteen RCTs (N = 1,314) were included in our meta-analysis. The present meta-analysis indicated that PRP injections reduced pain more effectively than HA injections in patients with KOA at six and 12 months of follow-up, as evaluated by the WOMAC pain score; the VAS pain score showed a significant difference at 12 months. Moreover, better functional improvement was observed in the PRP group, as demonstrated by the WOMAC function score at three, six, and 12months. Additionally, PRP injections did not display different adverse event rates compared with HA injections. Conclusion. In terms of long-term pain relief and functional improvement, PRP injections might be more effective than HA injections as a treatment for KOA. The optimal dosage, the timing interval and frequency of injections, and the ideal treatment for different stages of KOA remain areas of concern for future investigations.