Meta Analysis Of Platelet-rich Plasma Combined With Arthroscopy In Treatment Of Meniscus Injury

Objective:Evaluate the efficacy of platelet-rich plasma(PRP)combined with arthroscopic surgery in the treatment of meniscus injury,and provide evidence-based basis for clinical protocol optimization.Methods:Systematic retrieval of chinese and english databases Pubmed?Science Direct?Cochrane library?chinese journal full-text database,wanfang database and weip database PRP clinical comparative study of arthroscopic surgery alone to repair meniscus injury.The retrieval time is limited to January 01,2015 to December 20,2019.literature screening,data extraction and quality evaluation according to inclusion and exclusion criteria.the relevant data were analyzed by RevMan 5.3 software to compare the effects of the two surgical approaches on knee pain scores(VAS scores),knee injury and osteoarthritis scoring criteria(Lysholm scores)at different time points,and three scores of osteoarthritis index(WOMAC scores)in xi'an and Mc Master universities.Results:A total of 329 meniscal injuries were included in 9 studies,146 in arthroscopic group and 183 in PRP group.the follow-up time ranged from 1 to 42 months.Th ere was no significant difference in the VAS score of arthroscopic operation combine d with PRP in the group of arthroscopic operation at 1,6 and 12 months after opera tion.[MD=0.01,95%CI(-0.48,0.45),P>0.05][MD=0.84,95%CI(-1.7,-0.01),P)0.05][MD=-0.6,95%CI(-1.19,0.01),P)0.05].The WOMAC score of arthroscopic surgery combine d with PRP group was 3 months after operation[MD=-8.07,95%CI(-11.17,-4.89),P<005],and 6 months after operation was lower than that of simple operation group[M D=-7.96,95%CI(-11.44,-4.48),P<0.05],and the diference was statistically significant;but the WOMAC score of 1 year after operation was comparable between the two groups[MD=-6.61,95%CI(-16.64,3.41),P>0.05],and the difference was not statistically significant.Arthroscopic surgery combined with PRP group Lysholm score was bet ter than that of simple operation group at 1 month and 6 months after operation[M D=3.85,95%CI(1.25,6.44),P<0.05][MD=2.88,95%CI(0.13,5.63),P<0.05],the differen ce was statistically significant,and there was no statistical difference between the tw o groups Lysholm 1 year after operation[MD=5.88,95%CI(-8?72,20.48),P=0.43].Conclusion:For improving the knee function and delaying the progress of arthritis in patients with meniscus injury,the short-term effect of arthroscopic surgery combined with PRP scheme is better than that of simple arthroscopic surgery,but the long-term effect and pain relief are comparable.