Role of platelet-rich plasma in the treatment of osteoarthritis: a meta-analysis

Objective The clinical efficacy of platelet-rich plasma (PRP) in the treatment of osteoarthritis remains controversial. In this paper, we evaluated the clinical efficacy of PRP in the treatment of osteoarthritis using meta-analysis, providing evidence for the selection of clinical treatment options. Methods We performed a computer-based search of PubMed, Embase, and the Cochrane Library databases to retrieve articles using the search terms “platelet-rich plasma”, “osteoarthrosis”, and “knee joint”. Quality evaluation and data extraction were performed. The combined effect was assessed using RevMan 5.3 software. Results Five randomized controlled trials, involving 320 patients, were included in this study. No significant differences were observed in the International Knee Documentation Committee score, visual analog scale (VAS) score, or the absolute value of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score between the experimental and control groups. The absolute value of the VAS score and change in the WOMAC score were significantly decreased and patient satisfaction was increased in the experimental group, as compared with the control group. Conclusion The findings of this meta-analysis suggest that intra-articular injection of PRP is an effective treatment for osteoarthritis that can reduce post-operative pain, improve locomotor function, and increase patient satisfaction.

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Clinical efficacy of platelet-rich plasma as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury

Journal of International Medical Research ◽

10.1177/0300060520955059 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095505

Author(s):

Yaodong Wang ◽

Chi Yao ◽

Zhuo Yang ◽

Wenlai Guo

Keyword(s):

Adjuvant Therapy ◽

Failure Rate ◽

Clinical Efficacy ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Arthroscopic Repair ◽

Cochrane Library ◽

Control Group ◽

Meniscal Injury ◽

Active Flexion

Objective The clinical efficacy of platelet-rich plasma (PRP) as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury remains controversial. This meta-analysis was performed to evaluate the clinical efficacy of PRP in the treatment of meniscal injury and provide evidence for the selection of clinical treatment options. Methods A computer-based search of the PubMed, Embase, and Cochrane Library databases was performed to retrieve articles using the search terms “platelet-rich plasma” and “menisci.” Quality evaluation and data extraction were performed. The combined effect was assessed using RevMan version 5.3 software. Results Three randomized controlled trials and three cohort studies involving 293 patients were included in the meta-analysis. There were no significant differences in the International Knee Documentation Committee score or Lysholm score between the experimental and control groups. The failure rate and visual analog scale score were significantly lower and the degree of active flexion was significantly higher in the experimental group than in the control group. Conclusion The findings of this meta-analysis suggest that PRP injection can effectively enhance the efficacy of arthroscopic repair of meniscal injury, reduce the failure rate and severity of pain, and improve active flexion.

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Efficacy and Safety of Intra-Articular Platelet-Rich Plasma in Osteoarthritis Knee: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2021/2191926 ◽

2021 ◽

Vol 2021 ◽

pp. 1-14

Author(s):

Mao Hong ◽

Chongjie Cheng ◽

Xiaowei Sun ◽

Yan Yan ◽

Qidong Zhang ◽

...

Keyword(s):

Adverse Event ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Womac Score ◽

Adverse Event Rate ◽

Cochrane Library ◽

Secondary Outcome ◽

Efficacy And Safety ◽

Vas Score ◽

Subjective Score

Background. Knee osteoarthritis (KOA) is a common disease in aged adults. Intra-articular (IA) injection of platelet-rich plasma (PRP) therapy is an effective minimally invasive treatment for KOA. We aimed to compare the efficacy and safety of platelet-rich plasma (PRP) with placebo or other conservative treatments. Methods. We conducted a meta-analysis to identify relevant articles from online register databases such as PubMed, Medline, Embase, and the Cochrane Library. The primary outcomes were the visual analogue scale (VAS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and International Knee Documentation Committee (IKDC) subjective score. The secondary outcome was the adverse event rate. Results. A total of 895 articles were identified, of which 23 randomized controlled trials that met the inclusion criteria were determined as eligible. Compared with placebo, PRP had a lower VAS score and higher IKDC subjective score at the 6th month after treatment and significantly less WOMAC score during the follow-up period. Compared with oral NSAIDs, PRP gained a lower WOMAC score at the 6th month after treatment. The VAS score decreased after treatment when reaching PRP and CS. As compared to the HA, the VAS score, WOMAC score, and IKDC subjective score all revealed better PRP results. There were no significant differences in adverse event rates comparing PRP versus placebo or HA. Different PRP applications did not show significant differences in VAS score in the 1st month and WOMAC score in the 3rd month after treatment. Conclusion. To compare with the conservative treatments mentioned above, PRP is more effective in relieving symptoms. There were no significant differences between triple PRP application and single PRP application in short-term curative effect.

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The clinical efficacy of continuous renal replacement in the treatment of acute pancreatitis: a meta-analysis of randomized controlled trials

10.22541/au.161306018.81141533/v1 ◽

2021 ◽

Author(s):

sijia Ma ◽

mingming Zhao ◽

zhiyu Pan ◽

jiao Fan ◽

xuexue Zhang ◽

...

Keyword(s):

Acute Pancreatitis ◽

Randomized Controlled Trials ◽

Clinical Efficacy ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Review Author ◽

Inclusion Criteria ◽

Randomized Controlled

Abstract：Objective: The purpose of this study was to investigate the effect of continuous renal replacement therapy(CRRT) on patients with acute pancreatitis(AP). Methods: A comprehensive search of seven databases without language restrictions includes PubMed, Cochrane Library, Scopus, Embase, Web of Science, China National Knowledge Infrastructure(CNKI) and Wan fang database. Randomized controlled trials (RCTs) for the treatment of acute pancreatitis with CRRT were searched. All the included literatures were published before December 2020. Two review authors independently selected the study and extracted the data according to the inclusion criteria. A third review author will and discuss with the first two review authors and resolve the differences. Weighted mean difference(WMD), risk ratio (RR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of AP in CRRT and control treatment. Results: Fifty-three RCTs met the inclusion criteria and were used in the meta-analysis, with a total of 3,382 effective samples. A comprehensive review of the system shows that the mortality rate of the CRRT group was significantly lower than that of the control group, and the difference was statistically significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78, 95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6 clearance effect. According to liver function, the patients using CRRT had lower ALT and AST levels. In the same way, according to renal function, the patients using CRRT had lower SCr (WMD=-94.28, 95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003). Moreover, Results shown no statistical difference in Serum potassium level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups. Conclusions: Our findings suggest that treatment with CRRT for acute pancreatitis may be more beneficial than conventional treatment. However, high-quality studies with a larger sample size are still needed to confirm our results.

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BADUANJIN EXERCISE TO TREAT FOR LUMBAR DISC HERNIATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519421400601 ◽

2021 ◽

Author(s):

XIAOKUN LI ◽

SHUSHENG GUO ◽

HONG DONG ◽

LIMING ZHOU

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Data Extraction ◽

Lumbar Disc ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Treatment Efficiency ◽

Vas Score ◽

Long Time

This study aimed to systematically evaluate the effectiveness of Baduanjin in the treatment of lumbar disc herniation (LDH). We searched PubMed, the Cochrane Library, EMBASE, Web of Science (WOS), CNKI, and Wanfang Databases from their inception until August 1, 2021, to collect the randomized controlled trials (RCTs) of Baduanjin in the treatment of LDH. After literature screening, data extraction, and quality evaluation by two independent researchers, the RevMan 5.4 software was used for meta-analysis. A total of 13 studies, involving 853 patients were finally included. The results showed that compared with the control group, the Baduanjin group showed remarkably improved treatment efficiency ([Formula: see text], 95% CI (1.05, 1.23), [Formula: see text]), JOA score ([Formula: see text], 95% CI (0.56, 4.68), [Formula: see text]), and VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]). The Baduanjin group exhibited higher VAS scores than the control group in different intervention times (within 1 month, 1–2 months, and more than two months) ([Formula: see text]). Moreover, the JOA score of the Baduanjin was better than that of the control group in the presence of intervention for more than two months ([Formula: see text], 95% CI (1.05, 7.30), [Formula: see text]). In the comparison of exercise therapy, Baduanjin has more advantages than traditional rehabilitation training, as manifested by the improved VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]) and JOA score ([Formula: see text], 95% CI (1.63, 3.09), [Formula: see text]). Conclusion: Baduanjin can significantly improve the rehabilitation evaluation scores of LDH patients and the treatment efficiency, and its curative effect was more obvious in a long time.

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Effects of abdominal binders on postoperative pain and functional recovery: a systematic review and meta-analysis

Pain Medicine ◽

10.1093/pm/pnab099 ◽

2021 ◽

Author(s):

Xin Sun ◽

Qingchuan Wei ◽

Chenying Fu ◽

Qing Zhang ◽

Zejun Liang ◽

...

Keyword(s):

Postoperative Pain ◽

Abdominal Surgery ◽

Pulmonary Function ◽

Physical Function ◽

Functional Recovery ◽

Meta Analysis ◽

Forced Expiratory Volume ◽

Cochrane Library ◽

Control Group ◽

Vas Score

Abstract Objective This study aimed to assess the effectiveness of abdominal binders (ABs) on postoperative pain and functional recovery in patients receiving abdominal surgery. Methods The Pubmed, Embase, Cochrane Library, and PEDro databases were searched for clinical trials published up to November 30, 2019. Randomized controlled trials that compared the effects of wearing an AB to not wearing an AB in participants after abdominal surgery were included. The primary outcomes were pain, pulmonary function, and physical function, as assessed by the visual analog scale (VAS) score, a spirometry device, and the 6-min walk test (6MWT), respectively. The registration number of this review in PROSPERO is CRD42020165303. Results Fourteen trials involving 1317 participants were included. Pooled estimates for the VAS score and the 6MWT showed significant differences between the AB group and the control group, especially on the fourth day following surgery (Mean Difference (MD) = -2.82, 95% Confidence Interval (CI) -3.41 to -2.22, P < 0.00001; MD = 50.97 m, 95% CI 39.99 to 61.95 m, P < 0.00001). However, no significant differences were found in pulmonary function (forced vital capacity (FVC): MD = 0.01, 95% CI -0.29 to -0.32, P = 0.94; forced expiratory volume during 1 s (FEV1): MD = -0.05; 95% CI -0.24 to 0.14; p = 0.63; FEV1/FVC: MD = 3.14, 95% CI -2.78 to 9.06, P = 0.30). Conclusion ABs probably improve postoperative pain and physical function, especially on the fourth day or more following abdominal surgery, but they have no effects on pulmonary function.

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Can platelet-rich plasma enhance the effect of meniscus repair?:a meta-analysis of randomized controlled trials

10.21203/rs.3.rs-480962/v1 ◽

2021 ◽

Author(s):

Yulei Xie ◽

Shan Wang ◽

Ju Yang ◽

Anli Hu ◽

Qing Wu

Keyword(s):

Adverse Events ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Meniscus Repair ◽

Lysholm Score ◽

Cochrane Library ◽

Control Group ◽

Cure Rate ◽

Serious Adverse Events ◽

Meniscus Injury

Abstract Background: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP.Purpose: To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury.Methods: By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov, and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events. The risk of bias is assessed using Cochrane’s collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed.Results: The meta-analysis included eight RCTs and 431 patients. In general, compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P=0.002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 4.86, P=0.0009, 95%CI: 1.98–7.75) of patients with meniscus injury, but the PRP enhancement technique showed no benefit in improving the cure rate of meniscus repair (risk ratio [RR]: 1.22, P=0.06, 95%CI: 0.99–1.51). No serious adverse events were reported in any study. Conclusion: PRP deserves further consideration as an enhancement program for meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.

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Acupuncture Treatment for Cough-Variant Asthma: A Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6694936 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Jian Xiong ◽

WenChuan Qi ◽

Han Yang ◽

SiTing Zou ◽

Jing Kong ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Clinical Efficacy ◽

Acupuncture Treatment ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Efficacy And Safety ◽

Cough Variant Asthma ◽

Randomized Controlled

Background. In recent years, there have been many clinical reports on acupuncture treatment of cough-variant asthma, but no researcher has objectively analysed and evaluated the efficacy and safety of acupuncture treatment of cough-variant asthma from the perspective of evidence-based medicine. Objective. To systematically evaluate the clinical efficacy and safety of acupuncture in treating cough-variant asthma and to provide reference values for clinical decision-making. Methods. The comprehensive computer retrieval Chinese journal full-text database (CNKI), Chinese science and technology periodical database (VIP), ten thousand data knowledge service platform (WanFang Data), PubMed, Embase, and the Cochrane Library were used to collect literature for relevant randomized controlled trials (RCT) of acupuncture treatment of cough-variant asthma, as well as to retrieve papers and add reference retrieval after literature review, in accordance with the standard of literature filtering, data extraction, and quality evaluation. The data were meta-analysed using ReviewManager5.3 software recommended by Cochrane. Results. A total of 11 randomized controlled clinical studies were screened and included, comprising 929 patients. The results of the meta-analysis showed that, compared with the control group, acupuncture intervention on CVA could enhance the total clinical effectiveness rate, reduce the relapse rate of drug withdrawal, relieve symptoms of cough, phlegm, and diaphragmatic congestion, and improve lung function-related indicators and immune inflammation indicators. There were statistically significant differences in all efficacy evaluation criteria. Conclusion. The clinical curative effect of acupuncture treatment for cough-variant asthma is precise and has certain advantages in relieving symptoms and reducing the recurrence rate. However, the low quality of the evaluation in the RCT research literature is a problem, and more high-quality clinical randomized controlled trials are needed to further verify the comprehensive clinical efficacy and safety of this treatment. Registration number: PROSPERO (no. CRD42020155244) (https://www.crd.york.ac.uk/prospero/).

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Analgesic effectiveness of quadratus lumborum block for patients after abdominal surgery: a systematic review and meta-analysis

10.21203/rs.2.22940/v1 ◽

2020 ◽

Author(s):

Tianyu Liu ◽

Chao Xu ◽

He Zhu ◽

Xiuxiu Gao ◽

Lulu Guo ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Cesarean Section ◽

Abdominal Surgery ◽

Meta Analysis ◽

Opioid Consumption ◽

Cochrane Library ◽

Control Group ◽

Vas Score ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

Abstract Background: A series of studies have reported that quadratus lumborum block (QLB) can have a great postoperative analgesia for lower abdominal surgery. However, a meta-analysis of the analgesic effect of QLB in patients undergoing lower abdominal surgery has not been published.Methods： We searched the databases of Pubmed, Embase, Cochrane Library, and Web of Science (updated to October 15, 2019). We cumulative opioid consumption at 6, 12, 24 and 48h after surgery; pain score (rest and dynamic) at 6, 12, 24 and 48h after surgery; occurrence of common opioid-related complications at 24h after surgery . Opioid consumption as the main outcome.Results：Thirteen randomized controlled trials (RCTs) including 751 patients were analysed. Compared with control group, QLB group can effectively reduce 24 and 48h cumulative opioid consumption 10.1mg (95%CI: -13,-7.2; p<0.00001) and 16.22mg (95%CI: -19.39,13.03; p<0.00001) in patients with cesarean section, but can reduce effectively cumulative opioid consumption in patients undergoing laparoscopic surgery at 6, 12 and 24h. Posterior QLB group and transmuscular QLB group reduced 24h cumulative opioid consumption 4.03mg ( 95%CI: -7.89, -0.19; p=0.04) and 12.44mg ( 95%CI: -20.2, -4.68; p=0.002), respectively. QLB group reduced rest visual analogue scale (VAS) score at 12 , 24 and 48 h ,however, the effective reduction of rest VAS score in patients undergoing cesarean section only occurs at 24h after surgery.Conclusion：QLB seems to provide better analgesia for patients undergoing laparoscopic surgery than patients undergoing cesarean section. Transmuscular QLB appears to have reduced postoperative opioid consumption compared to posterior QLB. More future RCTs are needed to support our conclusions.

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EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211004277 ◽

2021 ◽

pp. 174749302110042

Author(s):

Grace Mary Turner ◽

Christel McMullan ◽

Olalekan Lee Aiyegbusi ◽

Danai Bem ◽

Tom Marshall ◽

...

Keyword(s):

Systematic Review ◽

Stroke Risk ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Cochrane Library ◽

Control Group ◽

Large Sample Size ◽

Hazard Ratios ◽

Increased Risk ◽

The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

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Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211032786 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110327

Author(s):

Weihua Liu ◽

Wenli Yu ◽

Hongli Yu ◽

Mingwei Sheng

Keyword(s):

Clinical Efficacy ◽

Lower Risk ◽

Gastrointestinal Endoscopy ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Similar Efficacy ◽

Cochrane Library ◽

Efficacy And Safety ◽

Inclusion Criteria ◽

Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

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