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Intra‐articular platelet‐rich plasma injections for knee osteoarthritis: An overview of systematic reviews and risk of bias considerations
Author(s) -
Xing Dan,
Wang Bin,
Zhang Wei,
Yang Ziyi,
Hou Yunfei,
Chen Yaolong,
Lin Jianhao
Publication year - 2017
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13233
Subject(s) - jadad scale , systematic review , medicine , cochrane library , medline , meta analysis , publication bias , physical therapy , intensive care medicine , political science , law
Objectives Numerous systematic reviews investigating the efficacy of platelet‐rich plasma (PRP) in treating knee osteoarthritis (OA) have been recently published. The purpose of the present study was (1) to perform an overview of overlapping systematic reviews investigating PRP for knee OA via evaluating methodological quality and risk of bias of systematic reviews and (2) to provide recommendations through the best evidence. Methods A systematic search of systematic reviews published through Feb 2017 was conducted using the MEDLINE, EMBASE and Cochrane Library. The methodological quality and risk of bias of included systematic reviews were assessed by AMSTAR instrument and ROBIS tool respectively. Best evidence choice procedure was conducted according to the Jadad decision algorithm. The systematic reviews with high quality of methodology and low risk of bias were selected ultimately. Results Ten systematic reviews were eligible for inclusion. The Jadad decision making tool suggested that the reviews with highest AMSTAR score should be selected. According to the ROBIS tool, there were 4 systematic reviews with low risk of bias and 6 with high risk of bias. As a result, two systematic reviews conducted by Dai et al and Meheux et al with highest AMSTAR score and low risk of bias were selected as the best evidence. Conclusions The present overview demonstrates that PRP is an effective intervention in treating knee OA without increased risk of adverse events. Therefore, the present conclusions may help decision makers interpret and choose PRP with more confidence.