富血小板血浆治疗对前交叉韧带重建术后疗效的影响：系统评价和Meta分析
简介
这项系统评价与meta分析纳入17项比较研究，评估富血小板血浆（PRP）辅助ACL重建后的疗效。合并随机与非随机研究时，PRP仅使6、12个月IKDC评分小幅提高，但仅纳入随机试验后差异消失；Lysholm评分、疼痛、客观稳定性及MRI均无一致获益，证据等级低至极低。因此，现有证据不支持ACL重建后常规使用PRP。
英文摘要
PURPOSE: To determine whether platelet-rich plasma (PRP) improves outcomes after anterior cruciate ligament reconstruction (ACLR). METHODS: MEDLINE via PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and the Latin American and Caribbean Health Sciences Literature database were searched through 16 July 2026 for comparative studies of PRP in primary ACLR. Outcomes included International Knee Documentation Committee (IKDC) and Lysholm scores, pain measured with a visual analogue scale, instrumented knee stability and magnetic resonance imaging (MRI) findings. Random-effects meta-analyses used restricted maximum likelihood estimation with Hartung-Knapp-Sidik-Jonkman adjustments. Post hoc sensitivity analyses included randomized controlled trials only. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Seventeen studies were included. In analyses combining randomized and nonrandomized studies, PRP was associated with small improvements in IKDC scores at 6 months (mean difference [MD], 1.66; 95% confidence interval [CI], 0.31-3.01) and 12 months (MD, 2.37; 95% CI, 1.19-3.54). These differences were no longer statistically significant in randomized-trial analyses. No robust differences were observed in Lysholm scores at 3, 6 or 12 months. A small late post-operative Lysholm difference persisted in the randomized-trial analysis but was based on two trials and was clinically trivial. Pain at approximately 12 months did not differ between groups (MD, -0.60; 95% CI, -1.64 to 0.44). No consistent benefits were demonstrated for objective knee stability or MRI outcomes. Certainty of evidence ranged from very low to low. CONCLUSIONS: PRP does not provide consistent or clinically meaningful benefits after ACLR. Current evidence does not support its routine use. LEVEL OF EVIDENCE: Level II.