Differentiating factors of intra-articular injectables have a meaningful impact on knee osteoarthritis outcomes: a network meta-analysis

作者：Mark Phillips, Christopher Vannabouathong, Tahira Devji, Rahil Patel, Zoya Gomes, Ashaka Patel, Mykaelah Dixon, Mohit Bhandari · 发表于：Knee Surgery Sports Traumatology Arthroscopy · 年份：2020 · DOI：10.1007/s00167-019-05763-1 · 被引用次数：65 · 研究领域：Osteoarthritis Treatment and Mechanisms、Total Knee Arthroplasty Outcomes、Periodontal Regeneration and Treatments

PURPOSE: There are a number of developments in intra-articular therapies that have been determined to be differentiating factors within the classes of treatments. This study evaluated the efficacy and safety of intra-articular treatments of primary knee osteoarthritis in the short term (3 months follow-up), using a network meta-analysis design, while taking within-class differentiating factors into consideration. METHODS: A literature search of MEDLINE (through OVID), EMBASE (through OVID), Cochrane Central Register of Controlled Trials for all trials comparing intra-articular therapies was conducted on November 12, 2018. The treatments assessed were high molecular weight and low molecular weight hyaluronic acid injections, extended-release corticosteroids, standard-release corticosteroids, platelet-rich plasma, and saline. A frequentist network meta-analysis was conducted for each outcome. RESULTS: Sixty-four articles (9710 patients) met the inclusion criteria. High molecular weight hyaluronic acid (- 0.53, 95% CI - 0.81 to - 0.25) and PRP (- 0.79, 95% CI - 1.32 to - 0.26) were the only treatments with a confidence interval that lay completely above the MID threshold; however, PRP results varied within sensitivity analyses. For the function analysis, high molecular weight hyaluronic acid (SMD - 0.76, 95% CI - 1.30 to - 0.22) was the only treatment with a confidence interval entirely above the MID. Extended-release corticosteroid demonstrated a possible benefit in functional ...