Сравнение эффективности использования обогащенной тромбоцитами плазмы и гиалуроновой кислоты в лечении дегенеративных заболеваний коленных суставов за 12 месяцев терапии по результатам визуально-аналоговой шкалы боли

Введение. Основными методами местного лечения остеоартрита коленного сустава (ОАКС) являются инъекции гиалуроновой кислоты (ГК) и обогащенной тромбоцитами плазмой (ОТП). Для объективизации эффективности этих методов часто используют визуально-аналоговую шкалу боли (ВАШ). До сих пор продолжаются дискуссии относительно того, какой из методов обладает наибольшей и продолжительной эффективностью в снижении болевого синдрома и улучшении функции сустава, что затрудняет осознанный выбор терапии.

Цель — определить эффективность лечения ОАКС, представленную через ВАШ, через 12 месяцев от начала внутрисуставного введения ОТП в сравнении с инъекциями ГК.

Материалы и методы. В работу включены только статьи на английском языке (с доступом к полным текстам) с описанием результатов лечения, представленных в виде ВАШ, пациентов, которые проходили лечение по поводу ОАКС с помощью ГК или ОТП в течение 12 месяцев.

Результаты. Первоначально отобрано 196 статей по теме, после удаления дубликатов осталось 170 статей, из которых только 4 подошли под критерии включения. На основе метаанализа значений ВАШ через 12 месяцев после начала терапии определен размер эффекта Hedges’ g — 0,26 (без статистической значимости). Гетерогенность между исследованиями была очень высокой (I2 = 93,48 %). В ходе тестов на публикационное смещение существенная предвзятость публикаций не выявлена. Согласно анализу Trim and Fill отсутствующие исследования, требующие коррекции из-за публикационного смещения, не найдены. В метаанализе продемонстрирован разнонаправленный эффект при использовании ОТП в лечении дегенеративных заболеваний коленных суставов, при этом вес каждого исследования различался, что могло повлиять на общий результат.

Вывод. Не выявлено значимых различий в результатах лечения ОАКС с применением ОТП и ГК через 12 месяцев.

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