A meta-analysis and systematic review of the therapeutic effects of arthroscopy combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis.

Abstract

Knee osteoarthritis (KOA) causes joint pain and dysfunction that severely affects the patient's ability to walk. Arthroscopy combined with intraarticular injection of sodium hyaluronate can slow the development of knee osteoarthritis, but there is a lack of rigorous evidence-based medicine evaluation, and it has not been recognized by some scholars at home and abroad. This paper analyzed the clinical efficacy of arthroscopy combined with intraarticular injection of sodium hyaluronate in slowing knee osteoarthritis based on Lysholm score. Randomized control trials of arthroscopy combined with intra-articular injection of sodium hyaluronate in the treatment of KOA on Chinese and English databases were retrieved using the following search terms: "knee osteoarthritis", "arthroscopic debridement of the joint", "articular cavity", and "sodium hyaluronate". The quality of the literature was evaluated using the Rev Man 5.3 software. Twelve literatures were included in the meta-analysis. Regarding Newcastle-Ottawa Scale (NOS) score, of the 12 literatures, 7 literatures (58.33%) scored 6-9 points, 3 literatures (25%) scored 3-5 points, and 2 literatures (16.67%) scored 0-2 points. With a random effects model used for analysis, the Lysholm score after 1 month of combined treatment was significantly higher than that before treatment [mean difference (MD) =30.65, 95% confidence interval (CI): 19.44, 41.86, P<0.01]. Further, after 3 months of combination treatment, the Lysholm score was significantly higher than that before treatment (MD =24.04, 95% CI: 13.75, 34.32, P<0.01), and the same trend was also observed after 6 months (MD =20.41, 95% CI: 14.43, 26.40, P<0.01) and after 12 months (MD =20.86, 95% CI: 8.99, 32.72, P<0.01) of combination treatment. Overall, the combined treatment achieved significantly better clinical therapeutic effects than the single treatments in the control group [odds ratio (OR) =7.51, 95% CI: 4.84, 11.65, P<0.01]. This meta-analysis has confirmed that arthroscopy combined with intra-articular injection of sodium hyaluronate demonstrates significant clinical therapeutic effects in the treatment of KOA. This combination treatment can significantly improve knee joint function, relieve clinical symptoms, and improve patients' quality of life.