PDF(Pubmed)
Abstract：
Objectives: The purpose of the present systematic review and meta-analysis is to summarize the current evidence on the role of bisphosphonates in the treatment of knee bone marrow lesions (BMLs), to understand whether they are truly effective in improving symptoms and restoring the subchondral bone status at imaging evaluation. Methods: A literature search was carried out on PubMed, Cochrane, and Google Scholar databases in accordance with the PRISMA guidelines. Potential risk of bias was evaluated using the Cochrane Risk of Bias 2 tool for randomized controlled trials (RCTs) and the ROBINS-I tool for non-randomized studies. Results: A total of 15 studies were included in the present systematic review and meta-analysis. Seven studies were RCTs, two were prospective cohort studies, three were retrospective, and three were case series. Our meta-analysis revealed that bisphosphonates did not significantly improve clinical scores or reduce BML size compared to placebo. Accordingly, the rate of adverse events was also non-significantly higher among bisphosphonate users versus placebo users. Conclusions: The main finding of the present meta-analysis and systematic review is that bisphosphonates show neither significant benefits nor significant adverse events when compared to placebo in the treatment of BMLs of the knee. Level of Evidence: Level IV systematic review of level II-III-IV studies. Level I meta-analysis of level I studies.
摘要：
目的：本系统综述和荟萃分析的目的是总结双膦酸盐在膝关节骨髓病变（BMLs）治疗中的作用的现有证据。在影像学评估中了解它们是否真正有效改善症状和恢复软骨下骨状态。方法：在PubMed上进行文献检索，科克伦,和GoogleScholar数据库符合PRISMA指南。使用CochraneRiskofBias2工具进行随机对照试验（RCTs），并使用ROBINS-I工具进行非随机研究，评估潜在的偏倚风险。结果：本系统综述和荟萃分析共纳入15项研究。七项研究是随机对照试验，两项是前瞻性队列研究，三个是回顾性的，三个是案例系列。我们的荟萃分析显示，与安慰剂相比，双膦酸盐并没有显着改善临床评分或减少BML大小。因此，与安慰剂使用者相比,双膦酸盐使用者的不良事件发生率也没有显著升高.结论：本荟萃分析和系统评价的主要发现是，与安慰剂相比，双膦酸盐在膝关节BML治疗中既没有显着益处，也没有显着不良事件。证据水平：II-III-IV级研究的IV级系统评价。I级研究的I级荟萃分析。
