{"title":"Clinical efficacy of multiple intra-articular injection for hip osteoarthritis.","authors":"Ting Lei, Yiyi Wang, Mingqing Li, Long Hua","doi":"10.1302/0301-620X.106B6.BJJ-2023-1272.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Intra-articular (IA) injection may be used when treating hip osteoarthritis (OA). Common injections include steroids, hyaluronic acid (HA), local anaesthetic, and platelet-rich plasma (PRP). Network meta-analysis allows for comparisons between two or more treatment groups and uses direct and indirect comparisons between interventions. This network meta-analysis aims to compare the efficacy of various IA injections used in the management of hip OA with a follow-up of up to six months.</p><p><strong>Methods: </strong>This systematic review and network meta-analysis used a Bayesian random-effects model to evaluate the direct and indirect comparisons among all treatment options. PubMed, Web of Science, Clinicaltrial.gov, EMBASE, MEDLINE, and the Cochrane Library were searched from inception to February 2023. Randomized controlled trials (RCTs) which evaluate the efficacy of HA, PRP, local anaesthetic, steroid, steroid+anaesthetic, HA+PRP, and physiological saline injection as a placebo, for patients with hip OA were included.</p><p><strong>Results: </strong>In this meta-analysis of 16 RCTs with a total of 1,735 participants, steroid injection was found to be significantly more effective than placebo injection on reported pain at three months, but no significant difference was observed at six months. Furthermore, steroid injection was considerably more effective than placebo injection for functional outcomes at three months, while the combination of HA+PRP injection was substantially more effective at six months.</p><p><strong>Conclusion: </strong>Evidence suggests that steroid injection is more effective than saline injection for the treatment of hip joint pain, and restoration of functional outcomes.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.106B6.BJJ-2023-1272.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: Intra-articular (IA) injection may be used when treating hip osteoarthritis (OA). Common injections include steroids, hyaluronic acid (HA), local anaesthetic, and platelet-rich plasma (PRP). Network meta-analysis allows for comparisons between two or more treatment groups and uses direct and indirect comparisons between interventions. This network meta-analysis aims to compare the efficacy of various IA injections used in the management of hip OA with a follow-up of up to six months.
Methods: This systematic review and network meta-analysis used a Bayesian random-effects model to evaluate the direct and indirect comparisons among all treatment options. PubMed, Web of Science, Clinicaltrial.gov, EMBASE, MEDLINE, and the Cochrane Library were searched from inception to February 2023. Randomized controlled trials (RCTs) which evaluate the efficacy of HA, PRP, local anaesthetic, steroid, steroid+anaesthetic, HA+PRP, and physiological saline injection as a placebo, for patients with hip OA were included.
Results: In this meta-analysis of 16 RCTs with a total of 1,735 participants, steroid injection was found to be significantly more effective than placebo injection on reported pain at three months, but no significant difference was observed at six months. Furthermore, steroid injection was considerably more effective than placebo injection for functional outcomes at three months, while the combination of HA+PRP injection was substantially more effective at six months.
Conclusion: Evidence suggests that steroid injection is more effective than saline injection for the treatment of hip joint pain, and restoration of functional outcomes.
目的:在治疗髋关节骨关节炎(OA)时,可采用关节腔内注射(IA)。常见的注射剂包括类固醇、透明质酸(HA)、局部麻醉剂和富血小板血浆(PRP)。网络荟萃分析允许在两个或多个治疗组之间进行比较,并使用干预措施之间的直接和间接比较。本网络荟萃分析旨在比较用于治疗髋关节 OA 的各种 IA 注射的疗效,随访时间长达六个月:本系统综述和网络荟萃分析采用贝叶斯随机效应模型评估所有治疗方案之间的直接和间接比较。从开始到2023年2月,对PubMed、Web of Science、Clinicaltrial.gov、EMBASE、MEDLINE和Cochrane图书馆进行了检索。纳入的随机对照试验(RCT)评估了HA、PRP、局麻药、类固醇、类固醇+麻药、HA+PRP以及作为安慰剂的生理盐水注射对髋关节OA患者的疗效:这项荟萃分析包括 16 项研究性试验,共有 1,735 人参与,结果发现类固醇注射对三个月后报告的疼痛的疗效明显优于安慰剂注射,但在六个月后未观察到明显差异。此外,在三个月时,类固醇注射比安慰剂注射对功能性结果更有效,而在六个月时,HA+PRP联合注射则更有效:结论:有证据表明,在治疗髋关节疼痛和恢复功能方面,类固醇注射比生理盐水注射更有效。
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