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Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials
Xie YL, Jiang H, Wang S, Hu AL, Yang ZL, Mou Z, Wang Y, Wu Q
Medicine. 2022;101(33):e30002
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. Therefore, a meta-analysis was conducted 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 PubMed, EMBASE, Cochrane Library Databases, clinicaltrials.gov, and the CNKI Database were searched from their inception till December 1, 2020. The RCTs reporting the outcomes of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events were included. The risk of bias was assessed using Cochrane collaborative tools. The simulated results were expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed. RESULTS The meta-analysis included 8 RCTs and 431 participants. Compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P = .002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 3.06, P < .0001, 95%CI: 1.70-4.42) of meniscus injury, but the PRP showed no benefit in improving the healing rate of meniscus repair (RR: 1.22, P = .06, 95%CI: 0.99-1.51). No serious adverse events were reported in any study. CONCLUSIONS PRP is safe and effective in improving the effect of meniscus repair as augment. High quality RCTs with long follow-up and definitive results are needed in the future to confirm the use and efficacy of PRP in meniscus tears.
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2.
Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection
Wu Q, Luo X, Xiong Y, Liu G, Wang J, Chen X, Mi B
Journal of orthopaedic surgery (Hong Kong). 2020;28(1):2309499019887660
Abstract
Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective for maintaining long-term beneficial effects without increasing the risk of intra-articular infection. However, few studies have compared the relative value of HA and PRP for OA treatment. PRP is more effective than HA for OA treatment in recent studies of this topic. We systematically searched Medline, SpringerLink, Embase, Pubmed, Clinical Trials.gov, the Cochrane Library, and OVID for all articles published through May 2018. Any study was included that compared the effect of HA and PRP (consistent treatment cycle and frequency of injection) on patient's pain levels and functionality improvements. Review Manager 5.3 was used to analyze data regarding these two primary outcomes. We included 10 total studies in the present meta-analysis. International Knee Documentation Committee (IKDC; MD: 10.37, 95% confidence interval (CI): 9.13 to 11.62, p < 0.00001), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC; MD: -20.69, 95% CI: -24.50 to -16.89, p < 0.00001, I(2) = 94%), and Visual Analogue Scale (VAS; MD: -1.50, 95% CI: -1.61 to -1.38, p < 0.00001, I(2) = 90%) differed significantly between the PRP and HA groups. Knee Osteoarthritis Outcome Scores (KOOSs) did not differ significantly (chi(2) = 23.53, I(2) = 41%, p = 0.11). Our hypothesis appears not to be confirmed because PRP and HA did not differ significantly with respect to KOOS score. However, the IKDC, WOMAC, and VAS scores differed significantly. Thus, based on the current evidence, PRP appears to be better than HA at achieving pain relief and self-reported functional improvement. Ia, meta-analyses of randomized clinical trials.
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3.
Lower limb arterial intervention or autologous platelet-rich gel treatment of diabetic lower extremity arterial disease patients with foot ulcers
Pu D, Lei X, Leng W, Zheng Y, Chen L, Liang Z, Chen B, Wu Q
Annals of translational medicine. 2019;7(18):485
Abstract
Background: To investigate whether lower limb vascular intervention or autologous platelet-rich gel (APG) treatment would benefit diabetic lower extremity arterial disease (LEAD) patients with foot ulcers. Methods: A total of 82 diabetic LEAD patients with foot ulcers were recruited and divided into three groups: group A (30 patients received basal treatment), group B (21 patients received basal and APG treatment), and group C (31 patients received basal and lower limb vascular intervention treatment). All patients underwent routine follow-up visits for 6 months. The baseline characteristics and parameters were examined. After treatment, changes in all parameters from baseline were recorded. The differences between groups and the relationship among each parameter were determined. Results: There were no differences in the ankle brachial index (ABI) or major amputation between groups A and B (P>0.05). Compared with groups A and B, the ABI and major amputation rate of group C were improved (P<0.05). There were no significant differences in transcutaneous oxygen partial pressure (TcPO2), the heal rate or minor amputation between groups A and C (P>0.05). Compared with groups A and C, TcPO2, the heal rate and minor amputation of group B were improved (P<0.05). The logistic regression analysis indicated that major amputation was mainly associated with the ABI, and minor amputation was mainly associated with TcPO2. Lower limb vascular intervention improves the ABI and reduces major amputation, and APG improves TcPO2 and reduces minor amputation. Conclusions: In diabetic LEAD patients with foot ulcers, major amputation was mainly associated with the ABI, while minor amputation was mainly associated with TcPO2. Interventional surgery (angioplasty) mainly improves the ABI, reduces the incidence of major amputation and improves the macrovasculature, and APG mainly improves local TcPO2, reduces the incidence of minor amputation and improves the microcirculation.
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4.
Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials
Mi B, Liu G, Zhou W, Lv H, Liu Y, Wu Q, Liu J
The Physician and Sportsmedicine. 2017;:1-8.
Abstract
OBJECTIVES Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE. METHODS A systematic search of the literature was conducted to identify related articles published from January 1980 to September 2016 in Pubmed, Embase, the Cochrane Library and SpringerLink. All studies that compared PRP with steroid administration on LE were included. Main outcomes were collected and analyzed by the Review Manager 5.1. RESULTS Eight randomized controlled trials (RCTs) that involved 511 patients met the criteria. This meta-analysis showed that there was no significant difference in pain relief in the short-term (2 to 4 weeks: SMD = 1.02, P = .03; 6 to 8 weeks: SMD = .73, P = .24) and the intermediate-term (12 weeks: SMD = -0.28, P = .35). Steroid exhibited a better efficacy of function in the short-term (2 to 4 weeks: SMD = .61, P < .001; 6 to 8 weeks: SMD = .53, P < .001). However, PRP was superior to steroid for pain relief in the long-term (half year: SMD = -1.6, P < .001; one year: SMD = -1.45, P < .001), and also for function improving in the intermediate-term (12 weeks: SMD = -0.53, P < .001) and the long-term (half year: SMD = -0.56, P < .001; one year: SMD = -0.7, P < .001). No serious adverse effects of treatment were observed in the two groups. CONCLUSION Treatment of patients with LE by steroid could slightly relieve pain and significantly improve function of elbow in the short-term (2 to 4 weeks, 6 to 8 weeks). PRP appears to be more effective in relieving pain and improving function in the intermediate-term (12 weeks) and long-term (half year and one year). Considering the long-term effectiveness of PRP, we recommend PRP as the preferred option for LE.
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5.
Systematic review of transfusion strategies for cardiac surgery . Chinese
Wu Q, Zhou R, Liu B
Shengwu Yixue Gongchengxue Zazhi/Journal of Biomedical Engineering. 2014;31((2):):319-26.
Abstract
This paper is aimed to assess the effects of red blood cell (RBC) transfusion on clinical outcomes in cardiac surgery. Trials were identified by computer searches of the Pubmed, MEDLINE, Cochrane Library (Issue 10, 2012), from January 1980 to October 2012. References in identified trials and review articles were checked and experts contacted to identify any additional trials. The homogeneous randomized controlled trials (RCTs) were analyzed with RevMan 5.1 software. Five trials involving a total of 1,203 patients were identified. The results of meta-analyses showed that restrictive transfusion strategies reduced the risk of receiving a RBC transfusion (MD = - 1.46, 95% CI -1.18(-) -1.1) and the volume of RBCs transfusion (RR = 0.69, 95% CI 0.53-0.89). No significant difference was noted between the two strategies in terms of mortality, adverse events and hospital or intensive care length of stay. Based on the results mentioned above, one can draw a conclusion that restrictive transfusion strategies reduced the risk of receiving RBC transfusion and the volume of RBCs transfused. Restrictive transfusion strategies did not appear to impact on the rate of adverse events and hospital or intensive care length of stay, compared to liberal transfusion strategies.