Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (6): 964-969.doi: 10.3969/j.issn.2095-4344.4005

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Platelet-rich plasma combined with microfracture versus microfracture in the treatment of knee cartilage lesions: a meta-analysis

He Xiangzhong1, Chen Haiyun1, Liu Jun1, Lü Yang1, Pan Jianke1, Yang Wenbin1, He Jingwen2, Huang Junhan1   

  1. 1Second Clinical School of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 2Department of Organ Transplantation, Second Hospital of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
  • Received:2020-03-26 Revised:2020-04-01 Accepted:2020-04-27 Online:2021-02-28 Published:2020-12-05
  • Contact: Chen Haiyun, Master, Chief physician, Second Clinical School of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • About author:He Xiangzhong, Master candidate, Physician, Second Clinical School of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • Supported by:
    a grant from Department of Finance of Guangdong Province, No. [2014]157, and [2018]8

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Abstract: OBJECTIVE: A large number of recent studies reported that microfracture combined with platelet-rich plasma has a good effect on osteochondral injury. This study systematically evaluated the clinical effect of arthroscopic platelet-rich plasma combined with microfracture versus microfracture in the treatment of knee cartilage lesions.
METHODS: A randomized controlled trial of arthroscopic platelet-rich plasma combined with microfracture in the treatment of knee cartilage lesions was searched in CNKI, Wanfang Database, VIP Database, Chinese Biomedical Literature Database, PubMed, Embase and Cochrane Library. The date was from January 2001 to March 2020. The data were extracted and the quality of the included literature was evaluated, and the Rev-Man5.3 software was used for meta-analysis.
RESULTS: (1) A total of seven randomized controlled trials were included, and the modified Jadad scale results showed that the scores of four studies were ≥ 4, which were high-quality literatures, and the scores of three studies were < 4, which were low-quality literatures. (2) Meta-analysis showed that the visual analogue scale score at 6 and 12 months, IKDC score at 12 and 24 months, Lysholm score at 12 and 24 months and WOMAC score at 12 months in the platelet-rich plasma combined with microfracture group were better than those in the microfracture group [MD=-0.40, 95%CI(-0.75, -0.05), Z=2.26, P=0.02; MD=-0.59, 95%CI(-0.86, -0.32), Z=4.30, P < 0.000 1; MD=7.70, 95%CI(4.22, 11.18), Z=4.34, P < 0.000 1; MD=10.99, 95%CI(6.79, 15.19), Z=5.13, P < 0.000 01; MD=4.98, 95%CI(2.31, 7.64), Z=3.66, P=0.000 3; MD=5.35, 95%CI(1.94, 8.77), Z=3.07, P=0.002; MD=-9.30, 95%CI(-16.50, 2.11), Z=2.53, P=0.01]. There was no significant difference in visual analogue scale score 24 months after operation and IKDC score 6 months after operation between the two groups (P > 0.05).
CONCLUSION: Platelet-rich plasma combined with microfracture for knee cartilage lesions can reduce the pain in the short and medium terms, enhance the joint function in the medium and long terms, and improve the postoperative experience. However, due to the limited number of included articles, more large-sample and high-quality randomized controlled trials are needed to provide further effective data. 

Key words: bone, materials, microfracture, platelet-rich plasma, knee joint, cartilage lesions, meta-analysis

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