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首页> 外文期刊>BMC Musculoskeletal Disorders >Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis
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Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis

机译：关节内血小板血小板血浆血浆注射与关节内皮质类固醇注射症对膝关节骨关节炎的症状管理：系统审查和荟萃分析

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Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee osteoarthritis (OA), particularly in the UK. IA platelet-rich plasma (PRP) injections are a promising alternative, but no systematic reviews to date have compared them to the current standard of care, IA CS injections. We aim to investigate the effect of IA PRP injections versus IA corticosteroid injections for the symptomatic management of knee OA. All published trials comparing IA PRP and CS injections for knee OA were included. MEDLINE, EMBASE, Scopus and Web of Science were searched through June 2020. Risk of bias was assessed using the Cochrane Risk of Bias tool. A random effects model was used to calculate standardized mean difference with 95% confidence interval in WOMAC/VAS score (or subscores), comparing IA PRP to CS injections across studies. Included were eight studies and 648 patients, 443 (68%) were female, mean age 59?years, with a mean BMI of 28.4. Overall, the studies were considered at low risk of bias. Compared with CS injections, PRP was significantly better in reducing OA symptoms (pain, stiffness, functionality) at 3, 6 and 9?months post-intervention (P??0.01). The greatest effect was observed at 6 and 9?months (??0.78 (??1.34 to ??0.23) standard mean deviations (SMD) and???1.63 (??2.14 to ??1.12) SMD respectively). At 6 months, this equates to an additional reduction of 9.51 in WOMAC or 0.97 on the VAS pain scales. At 6 months PRP allowed greater return to sporting activities than CS, measured by the KOOS subscale for sporting activity, of magnitude 9.7 (??0.45 to 19.85) (P?=?0.06). Triple injections of PRP, generally separated by a week, were superior to single injections over 12?months follow-up (P??0.01). IA-PRP injections produce superior outcomes when compared with CS injections for symptomatic management of knee OA, including improved pain management, less joint stiffness and better participation in exercise/sporting activity at 12?months follow-up. Giving three IA-PRP, with injections separated by a week, appears more effective than 1 IA-PRP injection. CRD42020181928 .
机译：关节内（IA）皮质类固醇（CS）注射是膝关节骨关节炎（OA）的症状管理的主要疗法，特别是在英国。 IA富含血小板的血浆（PRP）注射是一个有前途的替代品，但迄今为止没有系统的审查，并将其与目前的护理标准进行了比较IA CS注射。我们的目的是探讨IA PRP注射率为IA皮质类固醇注射对膝关系管理的影响。所有已公布的试验，比较IA PRP和CS注入膝关节OA。在2020年6月搜索了Medline，Embase，Scopus和Sciens网站。使用偏置工具的Cochrane风险评估偏见的风险。随机效果模型用于计算Womac / VAS评分（或子群）中的95％置信区间标准化平均差异，将IA PRP与研究相比。包括八项研究，648名患者，443名（68％）是女性，平均59岁？年，平均BMI为28.4。总体而言，研究以低偏见的风险考虑。与CS注射相比，PRP在干预后3,6和9的症状（疼痛，僵硬，功能）降低了OA症状（疼痛，僵硬，功能）（P？＆Δ01）。在6和9的时间内观察到最大的效果？（?? 1.34至0.23）标准平均偏差（SMD）和??? 1.63分别为1.63（?? 2.14至10）SMD）。在6个月，这相当于WAMAC中的9.51的额外减少或在VAS疼痛尺度上进行0.97。在6个月中，PRP允许比CS更大的返回体育活动，由KOOS子级进行体育活动，幅度为9.7（?? 0.45至19.85）（P？= 0.06）。 PRP的三重注射一般在一周内分离，优于12？几个月的单一注射（P？＆ 0.01）。与膝关节OA对症管理的CS注射相比，IA-PRP注射产生卓越的结果，包括改善疼痛管理，不那么关节僵硬，更好地参加运动/体育活动，在12个月后续行动。给出三个IA-PRP，用一周分开注射，似乎比1 IA-PRP注射更有效。 CRD42020181928。

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