富血小板血浆与补充黏液治疗膝关节骨关节炎的比较：一项6个月和12个月随访的随机对照试验的系统回顾和荟萃分析

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-07-18 DOI:10.1002/jeo2.70335

Kian Bagheri, Adithya Shekhar, Eric Kwok, Danton Dungy, Susan L. Stewart, Amir A. Jamali

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引用次数: 0

摘要

目的富血小板血浆（PRP）和透明质酸（HA）在过去的几十年里被用作膝关节骨关节炎（OA）的保守治疗。我们试图通过随机对照试验（rct）的系统评价和荟萃分析，在特定的中期终点比较PRP和HA的患者报告的结果。我们还试图确定血小板浓度对PRP和HA之间相对结果的影响。方法检索Embase、PubMed、Scopus和Cochrane数据库中与PRP和骨关节炎相关的相关词汇。选择比较PRP和HA治疗膝关节OA的随机对照试验。共纳入26项试验，涉及1650个膝关节。在基线、6个月和12个月的特定时间点，根据西安大略麦克马斯特大学骨关节炎指数（WOMAC）和视觉模拟量表（VAS）对两种治疗进行比较。结果在6个月和12个月时，PRP优于HA。在6个月和12个月时，它在VAS上也比HA有显著的益处。当将分析限制为6个月的随访并按血小板计数分离研究时，PRP在WOMAC评分的血小板计数对应于“大于基线至125万血小板/μL”和VAS评分的血小板计数对应于“75万至125万血小板/μL”方面比HA具有统计学意义上的显著优势。结论从整体上看，PRP在6个月和12个月的临床效果明显优于HA。这些发现必须根据本报告中所包括研究的许多制备方案和PRP分类来考虑。证据水平：1级，1级随机对照研究的系统评价。

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Platelet rich plasma compared to viscosupplementation in the treatment of knee osteoarthritis: A systematic review and meta-analysis of randomised controlled trials with 6 month and 12 month follow-up

Purpose

Platelet rich plasma (PRP) and hyaluronic acid (HA) have been utilised in the last few decades as a conservative treatment for knee osteoarthritis (OA). We sought to evaluate the patient reported outcomes at specific intermediate term endpoints comparing PRP to HA through a systematic review and meta-analysis of randomised controlled trials (RCTs). We also sought to determine the effect of platelet concentration on the relative outcomes between PRP and HA.

Methods

The Embase, PubMed, Scopus and Cochrane databases were searched for terms related to PRP and osteoarthritis. RCTs comparing PRP and HA in the treatment of knee OA were selected. A total of 26 trials with 1650 knees were included. The two treatments were compared based on the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) at specific time points of baseline, 6 months, and 12 months.

Results

PRP had a significant benefit over HA based on the WOMAC at 6 months and at 12 months. It also had a significant benefit over HA on the VAS at 6 months and at 12 months. When limiting the analysis to 6 month follow-up and separating the studies by platelet count, PRP had a statistically significant benefit over HA for platelet counts corresponding to ‘greater than baseline to 1,250,000 platelets/μL’ for the WOMAC score and platelet counts corresponding to ‘between 750,000 and 1,250,000 platelets/μL’ for the VAS score.

Conclusions

When taken as a whole, PRP demonstrates a significantly superior clinical result compared to HA at 6 months and 12 months. These findings must be considered in light of the numerous preparation protocols and PRP classifications detailed in this report for the included studies.