The efficacy of intra-articular injections in the treatment of knee osteoarthritis: A network meta-analysis of randomized controlled trials.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 18. BMC Musculoskelet Disord. 2021 Jun 16;22(1):550. doi: 10.1186/s12891-021-04308-3. Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. McLarnon M(1)(2), Heron N(3)(4)(5)(6). Author information: (1), Ballymena, UK. mmclarnon15@qub.ac.uk. (2)School of Medicine, Dentistry and Biomedical Science, Queens University Belfast, Belfast, United Kingdom. mmclarnon15@qub.ac.uk. (3)School of Medicine, Dentistry and Biomedical Science, Queens University Belfast, Belfast, United Kingdom. (4)Centre for Public Health Research, Queen's University, Belfast, UK. (5)UKCRC Centre of Excellence for Public Health Research (Northern Ireland), Belfast, United Kingdom. (6)Department of General Practice, Keele University, Newcastle, England. BACKGROUND: Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee osteoarthritis (OA), particularly in the UK. IA platelet-rich plasma (PRP) injections are a promising alternative, but no systematic reviews to date have compared them to the current standard of care, IA CS injections. We aim to investigate the effect of IA PRP injections versus IA corticosteroid injections for the symptomatic management of knee OA. METHODS: All published trials comparing IA PRP and CS injections for knee OA were included. MEDLINE, EMBASE, Scopus and Web of Science were searched through June 2020. Risk of bias was assessed using the Cochrane Risk of Bias tool. A random effects model was used to calculate standardized mean difference with 95% confidence interval in WOMAC/VAS score (or subscores), comparing IA PRP to CS injections across studies. RESULTS: Included were eight studies and 648 patients, 443 (68%) were female, mean age 59 years, with a mean BMI of 28.4. Overall, the studies were considered at low risk of bias. Compared with CS injections, PRP was significantly better in reducing OA symptoms (pain, stiffness, functionality) at 3, 6 and 9 months post-intervention (P