Platelet-rich plasma injection in the treatment of patellar tendinopathy: a systematic review and meta-analysis.

IF 1.6 4区医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2022-05-04 DOI:10.1186/s43019-022-00151-5

Apurba Barman, Mithilesh K Sinha, Jagannatha Sahoo, Debasish Jena, Vikas Patel, Suman Patel, Souvik Bhattacharjee, Debanjan Baral

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Abstract

Purpose: The objective of the study was to assess the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of patellar tendinopathy.

Methods: The PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases were searched for clinical trials which compared PRP injection with other 'active treatment' interventions ('Non-PRP' injection and 'No-injection' treatments) or 'No-active treatment' interventions. Randomized and non-randomized clinical trials that had been published up to 15 November 2021, were included in the meta-analysis. The primary outcome, pain relief, was measured on a 'visual analog scale.' Secondary outcomes were knee functional activities and quality of life (QoL). The PRISMA guidelines were followed throughout the study.

Results: Eight comparative studies were identified for inclusion in the meta-analysis. Assessment of these studies revealed that there were no significant differences in pain relief, functional outcomes, and QoL in the short, medium, and long term between PRP injection and Non-PRP injection interventions. Similarly, comparison of PRP injection to the No-active treatment intervention showed no differences in short- and medium-term pain relief. However, when PRP injection was compared to the No-injection treatment intervention extracorporeal shock wave therapy (ECWT), the former was found to be more effective in terms of pain relief in the medium term (mean difference [MD] - 1.50; 95% confidence interval [CI] - 2.72 to - 0.28) and long term (MD - 1.70; 95% CI, - 2.90 to - 0.50) and functional outcomes in the medium term (MD 13.0; 95% CI 3.01-22.99) and long term (MD 13.70; 95% CI 4.62-22.78).

Conclusions: In terms of pain relief and functional outcomes, the PRP injection did not provide significantly greater clinical benefit than Non-PRP injections in the treatment of patellar tendinopathy. However, in comparison with ESWT, there was a significant benefit in favor of PRP injection.

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富血小板血浆注射治疗髌骨肌腱病：系统回顾和荟萃分析。

目的：本研究旨在评估自体富血小板血浆（PRP）注射治疗髌腱病的疗效：方法：在 PubMed、MEDLINE、EMBASE、CINAHL 和 Cochrane Central Register of Controlled Trials 数据库中搜索比较 PRP 注射与其他 "积极治疗 "干预（"非 PRP "注射和 "无注射 "治疗）或 "无积极治疗 "干预的临床试验。荟萃分析纳入了截至 2021 年 11 月 15 日发表的随机和非随机临床试验。主要结果是疼痛缓解程度，采用 "视觉模拟量表 "进行测量。次要结果为膝关节功能活动和生活质量（QoL）。整个研究过程都遵循了 PRISMA 指南：荟萃分析确定了八项比较研究。对这些研究的评估结果显示，PRP 注射与非 PRP 注射干预在短期、中期和长期的疼痛缓解、功能结果和 QoL 方面没有显著差异。同样，将 PRP 注射与非主动治疗干预进行比较后发现，在短期和中期疼痛缓解方面没有差异。然而，当 PRP 注射与非注射治疗干预措施体外冲击波疗法（ECWT）进行比较时，发现前者在中期疼痛缓解方面更为有效（平均差 [MD] - 1.50; 95%置信区间[CI] - 2.72 to - 0.28）和长期（MD - 1.70; 95% CI, - 2.90 to - 0.50），以及中期（MD 13.0; 95% CI 3.01-22.99）和长期（MD 13.70; 95% CI 4.62-22.78）的功能结果：就疼痛缓解和功能结果而言，在治疗髌骨肌腱病时，PRP注射的临床疗效并不明显优于非PRP注射。不过，与 ESWT 相比，PRP 注射的疗效更明显。

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.