Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeli...Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.展开更多
目的:系统评价针刀联合关节腔内注射药物治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library中关...目的:系统评价针刀联合关节腔内注射药物治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library中关于针刀联合关节腔内注射药物治疗KOA的对比研究文献,检索时限均为建库至2022年10月31日。试验组采用传统针刀联合关节腔内注射药物治疗,对照组仅采用关节腔内注射药物治疗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Revman5.4软件进行Meta分析。结果:共检索到367篇文献,最终纳入11篇文献,共涉及1601例患者,其中试验组800例,对照组801例。Meta分析结果显示,试验组有效率、Lysholm膝关节评分高于对照组[RR=1.21,95%CI(1.16,1.25),P=0.000;MD=6.01,95%CI(3.82,8.20),P=0.000],膝关节疼痛视觉模拟量表评分、西安大略和麦克马斯特大学骨关节炎指数评分低于对照组[MD=-1.17,95%CI(-1.24,-1.09),P=0.000;MD=-6.94,95%CI(-8.31,-5.56),P=0.000]。结论:针刀联合关节腔内注射药物治疗KOA的临床疗效优于单纯关节腔内注射药物。展开更多
文摘Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.
文摘目的:系统评价针刀联合关节腔内注射药物治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library中关于针刀联合关节腔内注射药物治疗KOA的对比研究文献,检索时限均为建库至2022年10月31日。试验组采用传统针刀联合关节腔内注射药物治疗,对照组仅采用关节腔内注射药物治疗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Revman5.4软件进行Meta分析。结果:共检索到367篇文献,最终纳入11篇文献,共涉及1601例患者,其中试验组800例,对照组801例。Meta分析结果显示,试验组有效率、Lysholm膝关节评分高于对照组[RR=1.21,95%CI(1.16,1.25),P=0.000;MD=6.01,95%CI(3.82,8.20),P=0.000],膝关节疼痛视觉模拟量表评分、西安大略和麦克马斯特大学骨关节炎指数评分低于对照组[MD=-1.17,95%CI(-1.24,-1.09),P=0.000;MD=-6.94,95%CI(-8.31,-5.56),P=0.000]。结论:针刀联合关节腔内注射药物治疗KOA的临床疗效优于单纯关节腔内注射药物。