genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2026-32-1-132-143genort-3414Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESСравнительный анализ эффективности применения обогащенной тромбоцитами плазмы и гиалуронатов при лечении остеоартрита коленного сустава: метаанализ исследований с шестимесячным наблюдениемEfficacy of platelet-rich plasma in the treatment of pain syndrome in knee osteoarthritis: a meta-analysis of the studies with a 6-month follow-uphttps://orcid.org/0009-0004-3958-5349ПриезжеваЕ. С.PriezzhevaE. S.

Приезжева Елена Сергеевна — врач общей практики, ординатор.

Екатеринбург

Elena S. Priezzheva — General practitioner, resident.

Ekaterinburg

elena_priezjeva@mail.ruhttps://orcid.org/0000-0002-6331-0124СивковаН. И.SivkovaN. I.

Сивкова Надежда Ивановна — кандидат социологических наук, доцент кафедры.

Екатеринбург

Nadezhda I. Sivkova — Candidate of Social Sciences, Associate Professor.

Ekaterinburg

letica@mail.ruhttps://orcid.org/0000-0003-1261-3712ЖиляковА. В.ZhilyakovA. V.

Жиляков Андрей Викторович — доктор медицинских наук, доцент кафедры.

Екатеринбург

Andrey V. Zhilyakov — Doctor of Medical Sciences, Associate Professor of the Department.

Ekaterinburg

doctor.zhilyakov1975@yandex.ruhttps://orcid.org/0000-0001-5994-8558ВолокитинаЕ. A.VolokitinaE. A.

Волокитина Елена Александровна — доктор медицинских наук, профессор, заведующая кафедрой.

Екатеринбург

Elena A. Volokitina — Doctor of Medical Sciences, Professor, Head of the Department.

Ekaterinburg

volokitina_elena@rambler.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationУральский федеральный университет имени первого Президента России Б.Н. ЕльцинаРоссияUral Federal University named after the first President of Russia B.N. YeltsinRussian Federation202620022026321132143Copyright © Приезжева Е.С., Сивкова Н.И., Жиляков А.В., Волокитина Е.A., 20262026Приезжева Е.С., Сивкова Н.И., Жиляков А.В., Волокитина Е.A.Priezzheva E.S., Sivkova N.I., Zhilyakov A.V., Volokitina E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/3414Введение

Введение. В научной литературе представлено множество исследований, сравнивающих эффективность применения PRP-терапии, или обогащенной тромбоцитами плазмы (ОТП), и препаратов гиалуроновой кислоты (ГК) при остеоартрите коленного сустава, однако результаты носят противоречивый характер из-за методологических ограничений и высокой неоднородности протоколов лечения.

Цель работы — сравнить данные научных исследований об эффективности применения ОТП и препаратов ГК средней молекулярной массы в лечении больных остеоартритом коленного сустава.

Материалы и методы

Материалы и методы. Проведен поиск рандомизированных контролируемых исследований в базах PubMed, Embase и Cochrane Library за 2017–2024 гг. по следующим ключевым словам: osteoarthritis, knee joint, intra-articular injections, platelet-rich plasma, hyaluronic acid, WOMAC, meta-analysis. Включены исследования, в которых рассматривали пациентов с диагнозом «остеоартрит коленного сустава» любой степени тяжести, получавших внутрисуставные инъекции ОТП или ГК с оценкой выраженности болевого синдрома по шкале WOMAC. После строгого отбора включены четыре исследования с идентичными протоколами лечения.

Результаты

Результаты. В метаанализ включены данные 333 пациентов (164 в группе ОТП и 169 в группе ГК). Средний балл выраженности болевого синдрома по WOMAC через шесть месяцев от начала лечения (внутрисуставное введение) составил 4,52 (SD = 1,59) в группе ОТП и 4,95 (SD = 2,07) в группе ГК. Размер эффекта Hedges'g: 0,26 (95 % ДИ: –0,61–1,14; p = 0,336). Публикационное смещение отсутствовало (тест Эггера, p = 0,06).

Обсуждение

Обсуждение. В результате нашего исследования значимых различий между применением ОТП и ГК не выявлено, что противоречит ряду предыдущих метаанализов. Возможно, данный факт обусловлен использованием при нашем анализе более строгих критериев включения и оценкой препаратов ГК только средней молекулярной массы.

Заключение

Заключение. Проведенный метаанализ, направленный на сравнительную оценку эффективности применения ОТП и ГК средней молекулярной массы при лечении пациентов с остеоартритом коленного сустава, не выявил статистически значимых различий между группами при оценке выраженности болевого синдрома по шкале WOMAC через шесть месяцев от начала лечения, что свидетельствует о сопоставимой эффективности данных методов терапии.

Introduction The scientific literature database contains numerous studies comparing the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) preparations in knee osteoarthritis, but the results are contradictory due to methodological limitations and high heterogeneity of treatment protocols.

Purpose To compare the data from scientific studies on the effectiveness of using PRP and medium molecular weight HA preparations in the treatment of patients with knee osteoarthritis.

Materials and methods A search of randomized controlled trials was conducted in PubMed, Embase, and the Cochrane Library published in the period 2017–2024 using the following keywords: osteoarthritis, knee joint, intra-articular injections, platelet-rich plasma, hyaluronic acid, WOMAC, and meta-analysis. Studies that examined patients diagnosed with knee osteoarthritis of any severity who received intra-articular injections of PRP or HA and assessed pain using the WOMAC were reviewed. After rigorous selection, four studies with identical treatment protocols were included.

Results The meta-analysis included 4 studies involving 333 patients (164 in the PRP group and 169 in the HA group). The mean WOMAC pain score at 6 months after the start of treatment was 4.52 (SD = 1.59) in the PRP group and 4.95 (SD = 2.07) in the HA group. The effect size of Hedges' g was 0.26 (95 % CI: –0.61 to 1.14; p = 0.336). Egger's test did not reveal a statistically significant publication bias (p = 0.06).

Discussion Our study revealed no significant differences between the use of PRP and HA, which contradicts several previous meta-analyses. This may be due to the use of more stringent inclusion criteria in our analysis and the evaluation of HA preparations with only medium molecular weight.

Conclusion This meta-analysis was aimed to compare the effectiveness of using PRP and medium molecular weight HA in the treatment of patients with knee osteoarthritis and did not reveal statistically significant differences between the groups in severity of pain using the WOMAC system six months after the start of treatment, which indicates comparable effectiveness of these therapy methods.

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The authors declare that there are no conflicts of interest present.