髓芯减压植骨联合富血小板血浆与髓芯减压植骨治疗非创伤性股骨头坏死的Meta分析

Meta-analysis of core decompression and bone grafting combined with platelet-rich plasma and core decompression and bone grafting for treatment of non-traumatic femoral head necrosis

目的 比较髓芯减压植骨联合富血小板血浆(Platelet-rich plasma,PRP)与髓芯减压植骨治疗非创伤性股骨头坏死的临床疗效。方法 计算机检索Cochrane、PubMed、Embase、中国知网数据库关于比较髓芯减压植骨联合PRP与髓芯减压植骨治疗非创伤性股骨头坏死的文献,检索时间设置为2000-01-01—2022-02-15。观察指标为术后Harris髋关节评分、疼痛VAS评分、Harris髋关节评分优良率、股骨头塌陷率、全髋关节置换率。采用Review Manager 5.3软件进行Meta分析。结果 纳入10篇文献,9篇随机对照试验,1篇前瞻性病例对照研究。10篇文献中病例数共660例,其中观察组(髓芯减压植骨联合PRP)334例,对照组(单纯髓芯减压植骨)326例。Meta分析结果显示,观察组术后Harris髋关节评分、疼痛VAS评分、Harris髋关节评分优良率、股骨头塌陷率、全髋关节置换率均优于对照组,差异有统计学意义(P<0.05)。结论 髓芯减压植骨联合PRP可以改善髋关节功能,缓解髋关节疼痛,有效抑制或延缓非创伤性股骨头坏死。

Objective To compare the clinical efficacy of core decompression and bone grafting combined with platelet-rich plas-ma(PRP)and core decompression and bone grafting in the treatment of non-traumatic femoral head necrosis.Methods Computer retrieval of Cochrane,PubMed,Embase,and CNKI databases was achieved on the comparison of core decompression and bone grafting combined with PRP and core decompression and bone grafting in the treatment of non-traumatic necrosis of the femoral head,with the retrieval time set from January 1,2000 to February 15,2022.The observation indexes were Harris score,VAS score,the excellent rate of Harris score,the collapse rate of femoral head and the rate of total hip replacement.Meta analysis was performed with Review Manager 5.3.Results Ten articles,9 randomized controlled trials(RCTs)and 1 prospective case-control study were included.A total of 660 cases were reported in the 10 articles,including 334 cases in the observation group(core decompression and bone grafting combined with PRP)and 326 cases in the control group(core decompression and bone grafting only).The results of meta-analysis showed that Harris score,VAS score,the excellent rate of Harris score,the collapse rate of femoral head and the rate of total hip replacement in the observation group were better than those in the control group following surgical treatment,and the difference was statistically significant(P<0.05).Conclusion Core decompression and bone grafting combined with PRP can improve hip joint function,relieve the pain,and effectively inhibit or delay non-traumatic necrosis of the femoral head.