1.
The Application of Platelet-Rich Plasma for Patients Following Total Joint Replacement: A Meta-Analysis of Randomized Controlled Trials and Systematic Review
Shu H, Huang Z, Bai X, Xia Z, Wang N, Fu X, Cheng X, Zhou B
Frontiers in surgery. 2022;9:922637
Abstract
BACKGROUND The clinical efficacy of platelet-rich plasma (PRP) in the treatment of total joint replacement (TJR) remains inconclusive. In this paper, systematic review and meta-analysis was adopted to assess the efficacy of using PRP for the treatment of TJR. METHODS A comprehensive search of Medline, Embase, and Cochrane library databases for randomized controlled trial (RCT) articles recording data of PRP for TJR was conducted from inception to February 2022. Outcomes concerned were pain, range of motion (ROM), WOMAC score, length of hospital stay (LOS), hemoglobin (Hb) drop, total blood loss, wound healing rate, and wound infection. The methodological quality of the included RCTs was evaluated by using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was utilized to assess the level of evidence for the outcomes. Subgroup analysis was conducted according to the type of TJR. RESULTS Ten RCTs were included in the meta-analysis. In the TKA subgroup, the available data demonstrated that there were significant differences in the outcomes of pain and Hb drop, while it was the opposite of ROM, WOMAC score, LOS, total blood loss, wound healing rate, and wound infection. In the THA subgroup, no significant differences could be seen between two groups in the outcomes of LOS and wound infection. However, the PRP group gained a higher wound healing rate in the THA subgroup. CONCLUSION The application of PRP did not reduce blood loss but improved the wound healing rate. However, more prospective and multicenter studies are warranted to confirm these results.
2.
Minimally invasive surgery is superior to conventional craniotomy in patients with spontaneous supratentorial Intracerebral hemorrhage:a systematic review and meta-analysis
Xia Z, Wu X, Li J, Liu Z, Chen F, Zhang L, Zhang H, Wan X, Cheng Q
World Neurosurgery. 2018;115:266-273
Abstract
BACKGROUND Outcomes of minimally invasive surgery (MIS) versus conventional craniotomy (CC) for patients with spontaneous supratentorial intracerebral hemorrhage(SICH) have not been previously compared. We reviewed the current evidence regarding the safety and efficacy of MIS as compared with conventional craniotomy, in patients with SICH. METHODS We conducted a meta-analysis of studies that comparing MIS and CC in patients with computed tomography confirmed SICH, published from January 2000 to April 2018 in Medline, Embase, and Cochrane Controlled Trials Register (CCTR) based on PRISMA inclusion and exclusion criteria. Binary outcomes comparisons between MIS and CC were described using odds ratios (ORs). RESULTS Five randomized controlled trials (RCTs) and nine prospective controlled studies (non-RCTs) met the included criteria, involving 2466 patients. There was statistically significant difference in mortality rates between MIS and CC (OR, 0.76; 95% confidence interval [CI], 0.60-0.97). MIS associated with lower rates of complications in rebleeding (OR, 0.42; 95% CI, 0.28-0.64), and higher rates of good recovery compared with CC (OR, 2.27; 95% CI, 1.34-3.83). CONCLUSIONS Patients with SICH may benefit more from MIS than CC. Our study could help clinicians to optimize treatment strategies in SICH.