Yalong Di1, Changxu Han2, Liang Zhao2, Yizhong Ren3

Affiliations expand

· PMID： 29921309

· PMCID： PMC6008940

· DOI： 10.1186 / s13075-018-1621-0

背景：在这项研究中，我们评估了富血小板血浆（PRP）在治疗膝骨关节炎中是否优于透明质酸（HA）。

方法： 在对照试验的Cochrane中央登记册，PubMed和Embase数据库中搜索英语，人体体内研究与关节内PRP相比HA的症状性膝关节骨关节炎的治疗方法。使用以下关键字进行搜索：“富含血小板的血浆”，“ PRP”，“富含血小板的纤维蛋白”，“ PRF”，“血小板”，“血浆”，“关节炎”，“骨关节炎”，“性关节炎，和“变性”。

结果：分析了 7篇报道908例患者和908例膝盖的文章，其中平均年龄为59.8岁的男性为44％，女性为56％。所有研究均符合最小的临床重要差异标准，并显示PRP治疗的临床结局具有统计学上的显着改善，包括疼痛，身体功能和僵硬。除两项研究外，所有其他研究均表明PRP和HA在疼痛和功能的临床结局方面存在显着差异。

结论： PRP膝关节内注射可能是一种有效的替代方法，尤其是对于轻度OA患者。尽管一些研究表明PRP的效果并不比HA好，但我们发现效果并不差。需要进行一项大型，多中心，随机试验，以进一步评估PRP治疗膝关节炎的疗效。

试用注册： PROSPERO，CRD42016048394。2016年10月2日注册）。

关键字： 透明质酸；膝盖; 骨关节炎; 富含血小板的血浆。

Is local platelet-rich plasma injection clinically superior to hyaluronic acid for treatment of knee osteoarthritis? A systematic review of randomized controlled trials

Yalong Di1, Changxu Han2, Liang Zhao2, Yizhong Ren3

Affiliations expand

· PMID: 29921309

· PMCID: PMC6008940

· DOI: 10.1186/s13075-018-1621-0

Background: In this study, we evaluated whether platelet-rich plasma (PRP) is superior to hyaluronic acid (HA) in the treatment of knee osteoarthritis.

Methods: The Cochrane Central Register of Controlled Trials, PubMed, and Embase databases were searched for English-language, human in vivo studies on the treatment of symptomatic knee osteoarthritis with intra-articular PRP compared with HA. The following keywords were used for the search: "platelet-rich plasma," "PRP," "platelet-rich fibrin," "PRF," "platelet," "plasma," "arthritis," "osteoarthritis," "gonarthrosis," and "degeneration."

Results: Seven articles reporting 908 patients and 908 knees were analyzed, including 44% men and 56% women with a mean age of 59.8 years. All studies met the minimal clinically important difference criteria and showed statistically significant improvements in clinical outcomes, including pain, physical function, and stiffness, with PRP treatment. All except two studies showed significant differences between PRP and HA regarding clinical outcomes of pain and function.

Conclusions: PRP intra-articular injection of the knee may be an effective alternative treatment for knee OA, especially in patients with mild knee OA. Although some studies suggested that the effect of PRP was no better than HA, we found that it was no worse. A large, multicenter, randomized trial is needed to further assess the efficacy of PRP treatment for patients with knee OA.

Trial registration: PROSPERO, CRD42016048394 . Registered on October 2, 2016).

Keywords: Hyaluronic acid; Knee; Osteoarthritis; Platelet-rich plasma.