Long-term efficacy of three intra-articular injections in the treatment of knee osteoarthritis：a network meta-analysis
- VernacularTitle:3种关节内注射药物治疗膝骨关节炎长期疗效的网状Meta分析
- Author:
Yuwen HUANG
1
;
Zhitao HONG
2
;
Yongyuan HUANG
2
;
Hong SU
2
;
Kaining CHEN
3
;
Jie HAN
4
;
Yueping CHEN
4
;
Xiaofei WU
2
Author Information
1. Graduate School of Guangxi University of Chinese Medicine，Nanning 530001，China;Dept. of Orthopedics，The Second Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530011，China
2. Graduate School of Guangxi University of Chinese Medicine，Nanning 530001，China
3. Dept. of Orthopedics，The First Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530023，China
4. Dept. of Orthopedics，The Second Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530011，China
- Publication Type:Journal Article
- Keywords:
knee osteoarthritis;
intra-articular injection;
hyaluronic acid;
platelet-rich plasma;
micro-fragmented adipose tissue;
analgesia;
functional recovery
- From:
China Pharmacy
2026;37(14):1905-1911
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the long-term efficacy of intra-articular injection of hyaluronic acid （HA）， platelet-rich plasma （PRP）， and micro-fragmented adipose tissue （MFAT） in treatment of knee osteoarthritis （KOA）. METHODS Randomized controlled trials （RCTs） of KOA patients receiving intra-articular injection of the three agents were collected from PubMed， Web of Science， Embase， Cochrane Library， CNKI， Wanfang Data， VIP， Chinese Biomedical Literature Service System，and clinical trial registration platforms. The retrieval time limit was from January 2016 to December 2025. After screening the literature， extracting the data，and evaluating the quality of the literature， network meta-analysis was performed using RevMan 5.3 and Stata MP 16.0 software. RESULTS A total of 31 RCTs involving 2 964 patients were included. For pain relief， after 6 months of treatment， the Visual Analogue Scale （VAS） scores in the PRP+HA and PRP groups were significantly lower than those in the saline and HA groups （ P ＜0.05）， PRP+HA and PRP were ranked as the top two by surface under the cumulative ranking curve （SUCRA）. After 12 months of treatment， the VAS scores in the PRP group were significantly lower than those in the HA and saline groups （ P ＜0.05）， PRP and PRP+HA were ranked as the top two by SUCRA. For functional recovery， after 6 months of treatment， the Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） scores in the PRP group were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 12 months of treatment， the WOMAC scores in the MFAT， PRP and PRP+HA groups were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 6 and 12 months of treatment， International Knee Documentation Committee （IKDC） scores in the MFAT and PRP groups were significantly higher than the saline group （ P ＜0.05）， and after 12 months of treatment， the PRP group was significantly higher than the HA group （ P ＜0.05）. MFAT and PRP were ranked as the top two by SUCRA for both the WOMAC and IKDC scores. CONCLUSIONS For pain relief， PRP+HA showed a significant advantage at 6 months after treatment， whereas PRP alone demonstrated a notable superiority at 12 months after treatment. For functional recovery， MFAT exhibited a marked advantage at both 6 and 12 months after treatment.
