2025, Vol. 29 ›› Issue (28): 6138-6145

Platelet rich plasma versus hyaluronic acid in treatment of knee osteoarthritis: an overview of systematic reviews

Zhang Yunyi1, Liu Songtao1, Xie Shaodong2, Zhu Haifeng2, Qian Guifeng2, Huo Ming3, Zhou Jie2, Deng Zixuan1   

Abstract: OBJECTIVE: The quality of systematic reviews/meta-analyses directly affects the reliability of clinical decision-making basis. Currently, there is no literature quality research on the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis both domestically and internationally. This article will comprehensively evaluate the methodological quality, reporting quality, and evidence quality of the systematic reviews/meta-analyses of platelet rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis.
METHODS: Computer searches were conducted on CNKI, WanFang Data, VIP, CBM, PubMed, Embase, and The Cochrane Library. From the establishment of the database until January 24, 2024, all systematic reviews/meta-analyses treated with platelet rich plasma versus hyaluronic acid for knee osteoarthritis were collected. Two evaluators independently conducted literature screening and data extraction, and used the AMSTAR 2, PRISMA 2020, and GRADE systems to evaluate and summarize the methodological, reporting, and evidence quality of the included systematic reviews/meta-analyses.
RESULTS: A total of 18 qualified systematic reviews/meta-analyses were included, and the results showed that the efficacy and safety of platelet rich plasma might be better than that of hyaluronic acid. The methodological quality of all 18 studies was extremely low; 4 reports had poor quality and relatively serious information defects, while 14 reports had moderate quality and some information defects. Among the 275 outcome measures of 16 systematic reviews/meta-analyses, there were 9 medium quality evidence, 90 low-quality evidence, and 176 extremely low-quality evidence, with no high-quality evidence.
CONCLUSION: At present, the quality of systematic reviews/meta-analyses literature on the treatment of knee osteoarthritis with platelet rich plasma versus hyaluronic acid is relatively low. In the future, the authors of the systematic reviews need to strictly follow the entries of quality evaluation tools such as AMSTAR 2 and PRISMA 2020 in terms of plan registration, research type explanation, retrieval strategy, exclusion list, research site and funding source, bias risk analysis, publication bias evaluation, and public information acquisition, and conduct evidence quality evaluation on the combined results of the systematic reviews/meta-analyses to provide more reliable and rigorous evidence-based basis for clinical practice.

Key words: platelet rich plasma, hyaluronic acid, knee osteoarthritis, overview of systematic reviews, AMSTAR 2, PRISMA 2020, GRADE system