在治疗膝关节骨关节炎的血小板丰富血后的注射后方案:系统性审查
Oscar Paul Levine1, Koushik Kondapi1, Vehniah Kristin Tjong1
1Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
PM & R : the journal of injury, function, and rehabilitation
|March 25, 2024
概括
在膝关节骨关节炎中,为血小板丰富血 (PRP) 注射后的方案有很大差异. 这种变化,特别是在药物使用和活性方面,阻碍了对膝关节OA的最佳PRP治疗的理解.
科学领域:
- 整形外科 整形外科 整形外科
- 再生医学是一种再生医学.
- 运动医学 运动医学
背景情况:
- 富血小板血 (PRP) 注射越来越多地用于骨科疾病,如膝关节关节炎 (OA).
- 由于研究设计和协议的变化,PRP在膝关节OA的临床疗效的证据不一致.
- 骨关节炎的严重程度,PRP准备和结果措施的异质性使治疗评估复杂化.
研究的目的:
- 系统地审查和描述在临床试验中使用的注射后协议的多样性,以评估膝关节OA的PRP.
- 确定在膝关节OA中注射PRP后管理患者的常见做法和变化.
主要方法:
- 按照PRISMA指南进行了系统审查.
- 在CINAHL,MEDLINE和EMBASE数据库中进行搜索,从开始到2023年2月.
- 数据提取和偏差风险评估是重复完成的,重点是注射后协议组件.
主要成果:
- 分析了187项研究,揭示了PRP后注射方案的显著异质性.
- 注射后的NSAID限制有很大的差异 (42.8%的研究),对止痛,冷治疗和立即膝盖动员的建议也是如此.
- 活动限制 (35.3%) 和恢复活动指南 (20.3%) 被不一致地应用,大多数康复方案是基于家庭的 (93.3%).
结论:
- 在PRP后的膝关节OA注射方案中存在大量的异质性,对最佳建议缺乏共识.
- 许多概述的协议背后的逻辑不清楚,需要进一步的研究.
- 需要进行直接的比较研究,以确定哪些注射前和注射后的方案在膝盖骨关节炎患者中产生最佳结果.
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