Efficacy and safety of arthroscopic surgery combined with hyaluronic acid for meniscal injuries: A systematic review and meta-analysis of randomized controlled studies.
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Abstract
Objective: The efficacy and safety of arthroscopic surgery combined with hyaluronic acid in the treatment of meniscal injuries were evaluated by Meta-analysis to provide an evidence-based basis for the selection of clinical treatment options.
Methods: PubMed, Cochrane Library, EMBASE, Scopus, Web of Science English databases, and Chinese databases of China National Knowledge Infrastructure, WAN FANG, VIP, and China SinoMed had been searched up to June 2021. Quality evaluation was performed concerning the Cochrane Systematic Evaluation Tool. The obtained data were analyzed using the statistical software Review Manager 5.3.
Results: Eleven randomized controlled trials with a total of 955 patients were eventually included, 473 in the arthroscopic combined with hyaluronic acid group (combined treatment group) and 482 in the arthroscopy alone group (surgery group). The results of the study revealed that the excellent treatment [OR = 3.44, 95% CI (2.10, 5.65), p < .00,001], the VAS score [MD = -0.99, 95% CI (-1.50, -0.48), p = .0002], the Lysholm score [MD = 9.70, 95% CI (6.41, 12.99), p < .00,001] and the joint mobility [MD = 6.31, 95% CI (0.84, 11.78), p = .02] of the combined treatment group were significantly better than the surgery group, the difference was statistically significant. The complications rate was comparable in both groups [OR = 0.86, 95% CI (0.29, 2.53), p = .78], with no statistically significant difference.
Conclusion: Arthroscopic surgery combined with hyaluronic acid for meniscal injury can improve the efficiency of treatment compared with arthroscopic surgery alone, as well as the efficacy in relieving joint pain and improving joint function and mobility, without increasing the incidence of complications. Arthroscopic surgery combined with hyaluronic acid administration has good effectiveness and safety profile. Therefore, hyaluronic acid supplementation is recommended after arthroscopic surgery when treating meniscal injuries.
目的:通过meta分析评价关节镜手术联合透明质酸治疗半月板损伤的疗效和安全性，为临床治疗方案的选择提供循证依据。方法:检索截至2021年6月的PubMed、Cochrane Library、EMBASE、Scopus、Web of Science英文数据库，以及中国知网、万方、维普、中国医学信息网等中文数据库。采用Cochrane系统评价工具进行质量评价。使用统计软件Review Manager 5.3对获得的数据进行分析。结果:最终纳入11项随机对照试验，共955例患者，其中关节镜联合透明质酸组(联合治疗组)473例，单纯关节镜组(手术组)482例。研究结果显示，联合治疗组的优秀治疗[OR = 3.44, 95% CI (2.10, 5.65)， p < 0.00001]、VAS评分[MD = -0.99, 95% CI (-1.50， -0.48)， p = 0.0002]、Lysholm评分[MD = 9.70, 95% CI (6.41, 12.99)， p < 0.00001]、关节活动度[MD = 6.31, 95% CI (0.84, 11.78)， p = 0.02]均显著优于手术组，差异有统计学意义。两组并发症发生率相当[OR = 0.86, 95% CI (0.29, 2.53)， p = 0.78]，差异无统计学意义。结论:关节镜下手术联合透明质酸治疗半月板损伤较单纯关节镜下手术更能提高治疗效率，减轻关节疼痛，改善关节功能和活动能力，且未增加并发症的发生率。关节镜手术联合透明质酸给药具有良好的疗效和安全性。因此，在治疗半月板损伤时，建议在关节镜手术后补充透明质酸。
期刊介绍：
Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association.
The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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