Arthroscopic debridement combined with sodium hyaluronate injection for the treatment of senile knee osteoarthritis: a Meta-analysis of changes in pain, inflammatory factor, and joint function

doi:10.12307/2021.129

Abstract

Abstract:

OBJECTIVE: Relevant clinical studies have shown that arthroscopic debridement combined with sodium hyaluronate plays a positive role in the treatment of senile knee osteoarthritis, but its efficacy and safety are not completely clear, lack of sufficient evidence-based basis. Herein, we conducted a Meta-analysis on the clinical efficacy of arthroscopic debridement combined with sodium hyaluronate in the treatment of senile knee osteoarthritis.

METHODS: A systematic search of relevant literatures in PubMed, Cochrane library, EMbase, Web of Science, CNKI, CBM, WanFang and Baidu Scholar from January 1, 2016 to October 30, 2020 was performed. We collected all the randomized controlled trials of arthroscopic debridement combined with sodium hyaluronate injection in the treatment of senile knee osteoarthritis. Two researchers screened the study strictly according to the inclusion and exclusion criteria, and extracted data and evaluated the quality of the literature. Meta-analysis of the included literatures was processed by Revman5.3 software.
RESULTS: A total of 12 randomized controlled trials were collected in this meta-analysis, including 1 072 knees in the experimental group and 532 in the control group. The results of Meta-analysis showed that arthroscopic debridement combined with sodium hyaluronate injection in the treatment of senile knee osteoarthritis was superior to arthroscopic debridement alone with regard to the total clinical effective rate (relative risk (RR)=1.24, 95% confidence interval (CI): 1.15 to 1.33, P < 0.000 01), Lysholm score (standardized mean difference (SMD)=9.80, 95%CI: 8.09 to 11.51, P < 0.000 01), and Visual Analogue Scale score (MD=
-1.19, 95%CI: -1.58 to -0.80, P < 0.000 01). Compared with the arthroscopic debridement alone, the combination therapy showed a significant decrease in the levels of intra-articular interleukin-1 (MD=-9.95, 95%CI: -11.31 to -8.59, P < 0.000 01), interleukin-6 (MD=-33.68, 95%CI: -42.42 to -24.93, P < 0.000 01) and tumor necrosis factor-α (MD=-84.72, 95%CI: -91.49 to -77.95, P < 0.000 01). There was no significant difference in the incidence of complications between the two groups (RR=0.60, 95%CI: 0.30 to 1.18, P=0.14].
CONCLUSION: Compared with arthroscopic debridement alone, arthroscopic debridement combined with sodium hyaluronate is more effective in the treatment of senile knee osteoarthritis, which is embodied in relieving joint pain, improving knee joint function and reducing the level of inflammatory factors. However, more randomized controlled trials with high quality and large sample size are still needed in the future.

Key words: bone, knee, joint, osteoarthritis, sodium hyaluronate, arthroscopic, adverse reactions, Meta-analysis

CLC Number:

Huang Linfeng, Gu Yingxuan, Quan Xiaoming, He Wei, Chen Leilei. Arthroscopic debridement combined with sodium hyaluronate injection for the treatment of senile knee osteoarthritis: a Meta-analysis of changes in pain, inflammatory factor, and joint function[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(26): 4249-4256.

Figures/Tables 11

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