Comparative efficacy of osteochondral autologous transplantation and microfracture in the knee: an updated meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Qing-xin Han ◽  
Yi Tong ◽  
Lei Zhang ◽  
Jin Sun ◽  
Jia Ma ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Autologous Transplantation ◽  
Controlled Trials ◽  
Comparative Efficacy ◽  
Randomized Controlled ◽  
Osteochondral Autologous Transplantation

Osteochondral Autologous Transplantation Compared to Microfracture for Treating Osteochondral Defect: An Updated Meta-analysis of Randomized Controlled Trials

2017 ◽  
Vol 31 (04) ◽  
pp. 341-347 ◽  
Author(s):  
Zhao Haien ◽  
Wu Jiachang ◽  
Li Qiang ◽  
Mei Yufeng ◽  
Ji Zhenwei
Keyword(s):  
Articular Cartilage ◽  
Randomized Controlled Trials ◽  
Failure Rate ◽  
Cartilage Defect ◽  
Meta Analysis ◽  
Autologous Transplantation ◽  
Controlled Trials ◽  
Articular Cartilage Defect ◽  
Randomized Controlled ◽  
Osteochondral Autologous Transplantation

AbstractVarious techniques have proven to be effective for treating articular cartilage defect of the knee joint, but knowledge regarding which method is best still remains uncertain. Osteochondral autologous transplantation (OAT) provides hyaline or hyaline-like repair for articular defects, whereas microfracture (MF) provides fibrocartilage repair tissue. To compare the OAT with MF procedure for the treatment of articular cartilage defect, we present an update of previous meta-analysis of randomized controlled trials.We searched for the published results of relevant trials. Then, we pooled the outcome measures of the included trials for analysis. The outcome measures assessed in this study included the number of patients who reached excellent or good results, the patients returning to the activity, the International Cartilage Repair Society (ICRS) scores, the failure rate, and the osteoarthritis rate. Six studies and 294 patients were identified as eligible for data extraction and meta-analysis. The pooled result showed that there was no significant difference in the excellent or good results (relative risks [RRs], 1.27; 95% confidence intervals [CIs], 0.95 to 1.70; p = 0.11) and the rate of osteoarthritis (RRs, 0.64; 95% CIs, 0.37 to 1.13; p = 0.12). There were significant differences between the two groups in the scores of ICRS (mean differences [MDs], 12.51; 95% CIs, 10.55 to 14.47; p = 0.00001), the patients returning to activity (RRs, 2.04; 95% CIs, 1.36 to 3.07; p = 0.0006), and in the failure rate (RRs, 0.23; 95% CIs, 0.11 to 0.49; p = 0.0001). OAT has more advantages compared with MF procedure in referring to the index of return to activity, the scores of ICRS, and the rate of failure. However, the limitations restrict the generalizability of this study, and larger, sufficiently powered studies are necessary to evaluate the efficiency of OAT compared with MF procedure in the future.

scholarly journals Comparative Efficacy of Pharmacological and Nonpharmacological Interventions for Acne Vulgaris: A Network Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Qingyang Shi ◽  
Lizi Tan ◽  
Zhe Chen ◽  
Long Ge ◽  
Xiaoyan Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Physical Symptoms ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Comparative Efficacy ◽  
Inflammatory Lesions ◽  
Randomized Controlled

Acne has several effects on physical symptoms, but the main impacts are on the quality of life, which can be improved by treatment. There are several acne treatments but less evidence comparing their relative efficacy. Thus, we assessed the comparative efficacy of pharmacological and nonpharmacological interventions for acne. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to April 2019, to include randomized controlled trials for acne that compared topical antibiotics (TA), benzoyl peroxide (BPO), topical retinoids (TR), oral antibiotics (OA), lasers, light devices including LED device (LED), photodynamic therapy (PDT), and intense pulsed light, chemical peels (CP), miscellaneous therapies or complementary and alternative medicine (MTCAM), or their combinations. We performed Bayesian network meta-analysis with random effects for all treatments compared with placebo and each other. Mean differences (MDs) of lesions count and risk ratios of adverse events with their 95% credible intervals (CrIs) were calculated, and all interventions were ranked by the Surface Under the Cumulative Ranking (SUCRA) values. Additional frequentist additive network meta-analysis was performed to detect the robustness of results and potential interaction effects. Sensitivity analyses were carried out with different priors, and metaregression was to adjust for nine potential effect modifiers. In the result, seventy-three randomized controlled trials (27,745 patients with mild to moderate acne), comparing 30 grouped intervention categories, were included with low to moderate risk of bias. For adverse effects, OA had more risk in combination treatment with others. For noninflammatory lesions reduction, seventeen interventions had significant differences comparing with placebo and three interventions (TR+BPO: MD = −21.89, 95%CrI [−28.97, −14.76]; TR+BPO+MTCAM: −22.48 [−34.13, −10.70]; TA+BPO+CP: −20.63 [−33.97, −7.13]) were superior to others with 94, 94, and 91% SUCRA values, respectively. For inflammatory lesions reduction, nineteen interventions were significantly better than placebo, and three interventions (TR+BPO: MD = −12.13, 95%CrI [−18.41, −5.80]; TR+BPO+MTCAM: −13.21 [−.39, −3.04]; LED: −11.30 [−18.34, −4.42]) were superior to others (SUCRA: 81, 81, and 77%, respectively). In summary of noninflammatory and inflammatory lesions results, TR+BPO and TA+BPO were the best options compared to others. The frequentist model showed similar results as above. In summary, current evidence supports the suggestion that TR+BPO and TA+BPO are the best options for mild to moderate acne. LED is another option for inflammatory lesions when drug resistance occurs. All the combinations involved with OA showed more risk of adverse events than others. However, the evidence of this study should be cautiously used due to the limitations.

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