Peyman Mirghaderi, Ali Mortezaei, Amin Javidan, Amirhossein Ghaseminejad-Raeini, Behrad Nematollahi
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Data were collected on pain, hip range of motion, functional status, quality of life, and radiological outcomes. Meta-analysis was done on the above-listed outcomes.</p><p><strong>Results: </strong>From 18 RCTs involving 1648 patients, we analyzed the efficacy of various biological products. The mean age of patients was 60.2 years (SD 2.4), and the mean follow-up period was 7.22 months. PRP and HA treatments showed no statistically significant differences in VAS scores in the short-term (SMD = - 0.49, 95% CI, - 1.34-0.36), mid-term (SMD = - 0.25, 95% CI - 1.64-1.15), and long-term (SMD = - 0.22, 95% CI - 1.57-1.12) follow-ups. However, significant differences were found in WOMAC pain short-term (SMD = 0.40, 95% CI - 0.06-0.87), mid-term (SMD = 0.49, 95% CI - 0.85-1.83), and long-term outcomes (SMD = - 0.42, 95% CI - 0.80 to - 0.04). Complications were observed in HA (8%), Hylan G-F (4.9%), and GP-C (50%) groups, while PRP and BCC did not report any complications.</p><p><strong>Conclusion: </strong>Our meta-analysis indicates that biological products, particularly PRP and HA, provide varying degrees of pain relief and functional improvement in hip OA patients, with a generally acceptable safety profile. 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引用次数: 0
摘要
目的：本系统综述旨在评价各种生物制品，如富血小板血浆（PRP）、透明质酸（HA）以及联合治疗在缓解髋关节骨关节炎（OA）患者疼痛和改善功能方面的疗效和安全性。方法：我们的综述遵循PRISMA指南。从开始到2022年7月，在PubMed， Scopus, Embase， Web of Science和CENTRAL Cochrane数据库中检索文献，并根据先前设计的搜索字符串进行检索，并下载引文。我们纳入了随机对照试验（rct），涉及18岁以上髋关节OA患者，比较生物制品与安慰剂或其他干预措施。收集疼痛、髋关节活动度、功能状态、生活质量和放射学结果的数据。对上述结果进行meta分析。结果：从18项随机对照试验中，我们分析了各种生物制品的疗效，涉及1648例患者。患者平均年龄60.2岁（SD 2.4），平均随访时间7.22个月。PRP和HA治疗组在短期（SMD = - 0.49, 95% CI, - 1.34-0.36）、中期（SMD = - 0.25, 95% CI - 1.64-1.15）和长期（SMD = - 0.22, 95% CI - 1.57-1.12）随访中的VAS评分差异无统计学意义。然而，在WOMAC疼痛的短期（SMD = 0.40, 95% CI - 0.06-0.87）、中期（SMD = 0.49, 95% CI - 0.85-1.83）和长期结果（SMD = - 0.42, 95% CI - 0.80 - - 0.04）方面存在显著差异。HA组（8%）、Hylan G-F组（4.9%）、GP-C组（50%）出现并发症，PRP组和BCC组未见并发症。结论：我们的荟萃分析表明，生物制品，特别是PRP和HA，在髋关节OA患者中提供了不同程度的疼痛缓解和功能改善，具有普遍可接受的安全性。研究之间的显著异质性强调了进一步研究建立标准化治疗方案和长期疗效的必要性。试验注册号：CRD42022312562。
Efficacy and safety of biological products in hip osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.
Objective: This systematic review aims to evaluate the efficacy and safety of various biological products, such as platelet-rich plasma (PRP), hyaluronic acid (HA), and combination treatments, in alleviating pain and improving function in patients with hip osteoarthritis (OA).
Methods: Our review followed the PRISMA guidelines. Literature was searched in PubMed, Scopus, Embase, Web of Science, and CENTRAL Cochrane databases from the beginning until July 2022 hinged upon the previously designed search strings, and citations were downloaded. We included randomized controlled trials (RCTs) involving patients over 18 years old with hip OA, comparing biological products to placebo or other interventions. Data were collected on pain, hip range of motion, functional status, quality of life, and radiological outcomes. Meta-analysis was done on the above-listed outcomes.
Results: From 18 RCTs involving 1648 patients, we analyzed the efficacy of various biological products. The mean age of patients was 60.2 years (SD 2.4), and the mean follow-up period was 7.22 months. PRP and HA treatments showed no statistically significant differences in VAS scores in the short-term (SMD = - 0.49, 95% CI, - 1.34-0.36), mid-term (SMD = - 0.25, 95% CI - 1.64-1.15), and long-term (SMD = - 0.22, 95% CI - 1.57-1.12) follow-ups. However, significant differences were found in WOMAC pain short-term (SMD = 0.40, 95% CI - 0.06-0.87), mid-term (SMD = 0.49, 95% CI - 0.85-1.83), and long-term outcomes (SMD = - 0.42, 95% CI - 0.80 to - 0.04). Complications were observed in HA (8%), Hylan G-F (4.9%), and GP-C (50%) groups, while PRP and BCC did not report any complications.
Conclusion: Our meta-analysis indicates that biological products, particularly PRP and HA, provide varying degrees of pain relief and functional improvement in hip OA patients, with a generally acceptable safety profile. The significant heterogeneity among studies underscores the need for further research to establish standardized treatment protocols and long-term efficacy.
期刊介绍：
Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level.
The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.
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