Platelet-rich Plasma In The Treatment Of Knee Osteoarthritis:A Systematic Review And Meta-analysis Of Randomized Controlled Trials

Knee osteoarthritis is one of the common clinical diseases,but also more and more prominent social and public health problems.It is an important problem that affects the structure and function of human body,activities and social participation.With the aging of the population structure,the number of knee osteoarthritis patients in China is also increasing.Although there are many treatments for osteoarthritis of the knee,they do not reverse the degeneration of the knee cartilage.Therefore,it is very important to explore a new treatment method that can effectively improve the internal environment and structure of knee joint.Platelet-rich plasma generated by centrifugation of the whole blood,rich in high concentration of platelets.Injection of platelet rich plasma in knee can not only promote the repair of cartilage,but also has anti-inflammatory effects and provides cartilage repair suitable environment,and thus relieve knee pain symptoms.Studies have shown that the intraarticular injection of platelet-rich plasma in patients with early and middle knee osteoarthritis significantly improved WOMAC score and VAS score,and the knee function of the patients was improved to a certain extent.At the same time,platelet-rich plasma treatment of knee osteoarthritis did not increase the incidence of adverse reactions.However,since the preparation process of platelet rich plasma has not been unified at present,some scholars still doubt the effectiveness of this treatment.Therefore,this paper aims to explore the overall efficacy of platelet rich plasma in the treatment of knee osteoarthritis by different research units at present,so as to provide certain support for the better clinical application of this treatment.Objective:To obtain English-sourced randomized controlled trials for systematic evaluation and meta-analysis.Methods:Literatures from 2010 to date were retrieved from Pubmed,Cochrane Library,and Clinical Trials Electronic English database.The types of articles selected for the study were randomized controlled.Results:We included 14 randomized controlled studies of 1385 patients with a follow-up time range from 1 to 24 months.PRP was better compared to HA in function improvement(WOMAC total score)at 6 and 12 months of follow-up(SMD=-1.37,P<0.00001;12 months:SMD=-2.00,P=0.01);PRP was better than HA in function improvement(IKDC score)at 3 and 6 months of follow-up;PRP was better than HA in reducing joint pain(VAS pain score)(3 months:SMD=0.56,P<0.0001;6 months:SMD=-0.85,P<0.0001)at 6 and 12 months of follow-up;PRP was better than HA in reducing joint pain(WOMAC pain score)(6 months:SMD=-1.67,P=0.008;12 months:SMD=-1.36,P=0.02)at 2,6,and 12 months of follow-up;PRP was better than HA in improving patient health(EQ-VAS score)(SMD=0.20,P=0.04;6 months:SMD=0.53,P=0.01;12 months:SMD=0.35,P=0.001).We also found that compared with HA,PRP did not increase the risk of adverse events(RR:1.77,P=0.27).Restriction:Inclusion criteria are limited to literatures in the English language.Conclusion:Current evidence suggests that intraarticular injection of PRP is a more effective treatment for KOA than HA in patients with knee osteoarthritis.