Does intra-articular injection of PRP help patients with temporomandibular joint osteoarthritis after joint puncture? a systematic review and meta-analysis of randomized controlled trials.

Abstract

Objective: The aim of this study is to conduct a systematic review to evaluate whether intra-articular injection of platelet-rich plasma (PRP) after joint puncture can aid in the recovery of patients with temporomandibular joint osteoarthritis (TMJOA).

Methods: We searched PubMed, Cochrane Library, Embase and Web of Science as of March 3, 2024. Retrieved a total of 392 articles. We included all published randomized controlled trials (RCTs). All RCTs, including studies on PRP injection after joint puncture in patients with TMJOA. The primary outcome was pain reduction, and the secondary outcome was the improvement of maximal mouth opening (MMO) and joint sounds. All outcome measures were analyzed by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs).

Results: A total of 392 articles were retrieved, and ultimately, 6 articles met the inclusion criteria. The study involved 199 TMJOA patients. The results indicated that compared to the control group, PRP injection after joint puncture showed significant improvements in alleviating pain (SMD =-0.99; 95% CI =-1.35 ~-0.63; P <0.00001, I² = 59%) and MMO (SMD = 0.63; 95% CI = 0.30 ~ 0.95; P <0.0002, I² = 54%) among TMJOA patients. However, there was no significant improvement observed in terms of joint sounds (SMD =-0.34; 95% CI = -0.71 ~ 0.02; P = 0.06, I² = 0%) with the PRP.

Conclusions: Compared to joint puncture alone, the intra-articular injection of PRP after joint puncture was more effective in relieving pain. At 1-month and 6-month follow-ups, patients in the PRP group showed significant improvements in MMO compared to the control group. However, after 12 months of follow-up, limited evidence indicated significant improvements in MMO and joint sounds.