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关节镜手术联合富血小板血浆治疗半月板损伤的Meta分析
Hits: 3541   Download times: 644   Received:May 10, 2020    
作者Author单位UnitE-Mail
魏东 WEI Dong 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
陈翔 CHEN Xiang 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
顾晓东 GU Xiao-dong 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
李鹏翠 LI Peng-cui 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China  
卫小春 WEI Xiao-chun 山西医科大学第二医院骨科, 山西 太原 030001 Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China sdeygksys@163.com 
期刊信息:《中国骨伤》2021年34卷,第9期,第879-886页
DOI:10.12200/j.issn.1003-0034.2021.09.018
基金项目:国家国际科技合作专项项目(编号:2015DFA33050);山西省重点研发计划(指南)项目(编号:201803D421066);山西省科技基础条件平台项目(编号:201705D121010)


目的:探讨关节镜手术联合富血小板血浆(platelet-rich plasma,PRP)治疗半月板损伤的临床疗效。

方法:计算机检索PubMed、Science Direct、Cochrane library、中国期刊全文数据库、万方数据库和维普数据库中关节镜手术联合PRP与单纯关节镜手术修复半月板损伤的临床对照研究,检索时间自2015年1月至2019年12月。根据纳入和排除标准,进行文献筛查、数据提取并评价其方法学质量。采用RevMan 5.3软件比较两种治疗方式术后1,6,12个月的膝关节疼痛视觉模拟评分(visual analogue scale,VAS),Lysholm评分和术后3,6,12个月西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)。

结果:共纳入9项研究,329例半月板损伤患者,关节镜手术联合PRP组146例,单纯关节镜手术组183例。两组术后1、6、12个月VAS评分比较差异无统计学意义(P>0.05)。两组术后1,6个月Lysholm评分[MD=3.85,95% CI (1.25,6.44),P<0.05],[MD=2.88,95% CI (0.13,5.63),P<0.05]比较差异有统计学意义;术后12个月Lysholm评分比较差异无统计学意义[MD=5.88,95% CI (-8.72,20.48),P=0.43]。两组术后3、6个月WOMAC比较差异有统计学意义[MD=-8.07,95% CI (-11.17,-4.89),P<0.000 01],[MD=-7.96,95% CI (-11.44,-4.48),P<0.000 01];但术后12个月WOMAC评分比较差异无统计学意义[MD=-6.61,95% CI (-16.64,3.41),P>0.05]。

结论:关节镜手术联合PRP修复半月板损伤在改善膝关节功能,延缓关节炎方面短期疗效优于单纯关节镜手术,但两者长期疗效及缓解疼痛方面疗效相当。
[关键词]:关节镜  富血小板血浆  胫骨半月板损伤  Meta分析
 
Arthroscopic surgery combined with platelet-rich plasma for meniscus injury: a Meta-analysis
Abstract:

Objective: To evaluate clinical efficacy of arthroscopic with platelet-rich plasma(PRP) in treating meniscus injury.

Methods: From January 2015 to December 2019,clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed,Science Direct,Cochrane library,Chinese Journal Full-text Database,Wanfang and VIP database. Literature screening,data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1,6 and 12 months after opertaion between two groups were compared,and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3,6 and 12 months after opertaion between two groups were also compared.

Results: Totally 9 literatures and 329 patients with meniscal injuries were screened,include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1,6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups[MD=3.85,95%CI(1.25,6.44),P<0.05],[MD=2.88,95%CI(0.13,5.63),P<0.05];while there was no difference at 12 months[MD=5.88,95%CI(-8.72,20.48),P=0.43]. There were differneces in WOMAC score at 3 and 6 months after operation between two groups[MD=-8.07,95%CI(-11.17,-4.89),P<0.000 01],[MD=-7.96,95%CI(-11.44,-4.48),P<0.000 01];and no difference at 12 months after operation[MD=-6.61,95%CI(-16.64,3.41),P>0.05].

Conclusion: Arthroscopic with PRP for repair meniscus injury has short-term efficacy of knee function and delay arthritis,while has similar effect in long-term clinical efficacy and relieve pain.
KEYWORDS:Arthroscopes  Platelet-rich plasma  Tibial meniscus injuries  Meta-analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:魏东,陈翔,顾晓东,李鹏翠,卫小春.关节镜手术联合富血小板血浆治疗半月板损伤的Meta分析[J].中国骨伤,2021,34(9):879~886
英文格式:WEI Dong,CHEN Xiang,GU Xiao-dong,LI Peng-cui,WEI Xiao-chun.Arthroscopic surgery combined with platelet-rich plasma for meniscus injury: a Meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(9):879~886
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