Comparison between intra-articular injections of corticosteroids, hyaluronic acid, PRP and placebo for thumb base osteoarthritis: A frequentist network meta-analysis
Thakker, Arjura Sharma, Sanjeev Chand Dias, Joseph
Thakker, Arjura
Sharma, Sanjeev Chand
Dias, Joseph
Abstract
Background and aims: Current evidence for the use of intra-articular injections for thumb base osteoarthritis (TBOA) is equivocal. This study aims to investigate the efficacy of intra-articular corticosteroids, hyaluronic acid and platelet-rich plasma.
Methods: A Frequentist network meta-analysis was conducted comparing outcomes at short (≤3 months) and medium-term (>3-12 months) time points.
Results: Data from 7 RCTs and 1 non-RCT (446 patients) were collected, consisting of corticosteroids (n = 7), hyaluronic acid (n = 7), platelet-rich plasma (n = 2) and placebo (n = 2). At the short-term time point, no intra-articular injection demonstrated superiority over placebo at reducing pain. At the medium-term time point, superiority of platelet-rich plasma at reducing pain over placebo and corticosteroids was seen following sensitivity analysis (RCTs only) (SMD -1.48 95 % CI -2.71; -0.25). No injection proved superior at improving function at short or medium-term time points.
Conclusions: Overall, despite the promising result for platelet-rich plasma, the evidence quality was limited to two studies only justifying the need for further and larger methodologically robust trials investigating corticosteroids, hyaluronic acid and platelet-rich plasma vs each other and placebo.
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Date
2023-10-11
Type
Article
Subject
Hyaluronic acid, Meta-analysis, Osteoarthritis, PRP, Steroid, Thumb base
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Citation
Thakker, A., Sharma, S. C., Johnson, N., & Dias, J. J. (2023). Comparison between intra-articular injections of corticosteroids, hyaluronic acid, PRP and placebo for thumb base osteoarthritis: A frequentist network meta-analysis. Journal of orthopaedics, 45, 78–86. https://doi.org/10.1016/j.jor.2023.09.017