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

Objective To evaluate the efficacy and side effects of platelet-rich plasma in the treatment of knee osteoarthritis.Methods Randomized controlled trials on PRP for patients with KOA were searched in pubmed,EMBASE,Cochrane library,Web-science,CNKI,Wanfang,VIP Database and CBM.Literatures were screened according to the inclusion and exclusion criteria,and evaluated by the quality and bias risk.A meta-analysis was performed to compare the efficacy between the pre-treatment and post-treatment of PRP and the efficacy and the side effects between the PRP treatment and other conservative methods.Results A total of 1464 patients in 14 RCTs were included,the follow-up time ranging from 1 month to 12 months.Intra-articular injections of PRP obtained significantly favorable knee scores at the post-treatment 1^st month?WMD=34.56,P=0.02?,3^rd month?WMD=27.73,P<0.0001?,6^th month?SMD=2.38,P=0.0001?and 12^th month?SMD=1.69,P=0.001?.At the 6^th month,PRP improved the knee function better than HA?SMD=-0.47,P=0.003?.At the 12^th month PRP was significantly superior to HA in relieving knee pain?SMD=-0.55,P=0.0007?and improving knee function?SMD=0.88,P<0.0001?.The efficacy of PRP on improving knee function was lower than that of PRP combined with HA at 1^st,3^rd and 12^th month(P=0.004 for 1^st month,P=0.01 for 3^rd month and P=0.03 for 12^th month).At the 6^thh and 12^th month,PRP relieved pain and improved knee function better than ozone?P<0.05?.At each follow-up period,PRP and glucocorticoid had similar efficacys in relieving pain and improving knee function?P>0.05?.In terms of side effects,PRP did not increase the risk of adverse events than HA?OR=0.96,P=0.85?.Conclusion Compared with HA and ozone,Intra-articular injection of PRP is a more effective drug in the treatment of KOA,and Intra-articular injection of PRP combined with HA is better than Intra-articular injection of PRP alone in the treatment of KOA.