■当治疗髋关节骨关节炎(OA)时,可以使用关节内(IA)注射。常见的注射剂包括类固醇,透明质酸(HA),局部麻醉,和富含血小板的血浆(PRP)。网络荟萃分析允许两个或多个治疗组之间的比较,并使用干预措施之间的直接和间接比较。该网络荟萃分析旨在比较用于治疗髋关节OA的各种IA注射的疗效,并进行长达6个月的随访。
■这项系统综述和网络荟萃分析使用贝叶斯随机效应模型来评估所有治疗方案之间的直接和间接比较。PubMed,WebofScience,临床试验.gov,EMBASE,MEDLINE,从成立到2023年2月,搜索了Cochrane图书馆。评估HA疗效的随机对照试验(RCT),PRP,局部麻醉,类固醇,类固醇+麻醉剂,HA+PRP,注射生理盐水作为安慰剂,纳入了髋关节OA患者。
■在对16项RCT的荟萃分析中,共有1,735名参与者,发现在三个月时,类固醇注射对报告的疼痛明显比安慰剂注射更有效,但在6个月时没有观察到显著差异。此外,3个月时,类固醇注射比安慰剂注射更有效,而HA+PRP联合注射在6个月时更有效。
■有证据表明,类固醇注射治疗髋关节疼痛比生理盐水注射更有效,和功能结果的恢复。
UNASSIGNED: Intra-articular (IA) injection may be used when treating hip osteoarthritis (OA). Common injections include steroids, hyaluronic acid (HA), local anaesthetic, and platelet-rich plasma (PRP). Network meta-analysis allows for comparisons between two or more treatment groups and uses direct and indirect comparisons between interventions. This network meta-analysis aims to compare the efficacy of various IA injections used in the management of hip OA with a follow-up of up to six months.
UNASSIGNED: This systematic review and network meta-analysis used a Bayesian random-effects model to evaluate the direct and indirect comparisons among all treatment options. PubMed, Web of Science, Clinicaltrial.gov, EMBASE, MEDLINE, and the Cochrane Library were searched from inception to February 2023. Randomized controlled trials (RCTs) which evaluate the efficacy of HA, PRP, local anaesthetic, steroid, steroid+anaesthetic, HA+PRP, and physiological saline injection as a placebo, for patients with hip OA were included.
UNASSIGNED: In this meta-analysis of 16 RCTs with a total of 1,735 participants, steroid injection was found to be significantly more effective than placebo injection on reported pain at three months, but no significant difference was observed at six months. Furthermore, steroid injection was considerably more effective than placebo injection for functional outcomes at three months, while the combination of HA+PRP injection was substantially more effective at six months.
UNASSIGNED: Evidence suggests that steroid injection is more effective than saline injection for the treatment of hip joint pain, and restoration of functional outcomes.