Meta-analysis of the efficacy of platelet-rich plasma combined with cannulated screw fixation for the treatment of femoral neck fracture / 中国组织工程研究

ABSTRACT

BACKGROUND: Numerous studies have reported the effectiveness of platelet-rich plasma in promoting and improving bone healing. However, due to the limitations of methods, follow-up and study design, many orthopedicians still doubt the clinical effect of platelet-rich plasma combined with cannulated screw fixation in the treatment of fracture and nonunion. OBJECTIVE: To evaluate the difference in efficacy between platelet-rich plasma combined with cannulated screw fixation and simple cannulated screw fixation in the treatment of femoral neck fracture using meta-analysis system. METHODS: The Cochrane Library, PubMed, Wanfang Medical Network, China National Knowledge Infrastructure, and China Journal Full-text Database were used to search and collect clinical randomized controlled trials of platelet-rich plasma combined with cannulated screw fixation and cannulated screw fixation for the treatment of femoral neck fractures. Two reviewers independently evaluated the quality of the included studies, extracted data and checked each other. Meta-analysis was utilized to analyze the collected data with RevMan 5. 3 software. RESULTS AND CONCLUSION: (1) Seven clinical randomized controlled trials were selected for meta-analysis, totally 760 patients. There were 380 cases undergoing platelet-rich plasma combined with cannulated screw fixation and 380 cases undergoing cannulated screw fixation. (2) The meta-analysis showed that compared with the cannulated screw fixation group, fracture healing time was shorter [MD=-1. 86, 95%CI(-2. 97, -0. 75), P=0. 001]; healing rate was higher [OR=6. 51, 95%CI(3. 36, 12. 62), P < 0. 000 01]; necrosis rate was lower [OR=0. 25, 95%CI(0. 15, 0. 44), P < 0. 000 01]; Harris scores at 1, 3, 6, 9, and 12 months postoperatively were higher [MD=4. 95, 95%CI(4. 12, 5. 77), P < 0. 000 01; MD=19. 78, 95%CI(18. 45, 21. 11), P < 0. 000 01; MD=17. 16, 95%CI(10. 39, 23. 92), P < 0. 000 01; MD=12. 66, 95%CI(10. 60, 14. 71), P < 0. 000 01; MD=10. 17, 95%CI(5. 98, 14. 36), P < 0. 000 01] in the platelet-rich plasma combined with cannulated screw fixation group. (3) Platelet-rich plasma combined with cannulated screw fixation for femoral neck fracture is more effective than that of cannulated screw fixation alone. Combined treatment can accelerate the fracture healing of patients, improve the healing rate, reduce necrosis rate, and promote the recovery of postoperative hip joint function.