List of papers included in this meta-analysis.

BackgroundKnee osteoarthritis (KOA) is a common degenerative joint disease that primarily affects the elderly individuals. Traditional treatments include medications and physical therapy, but recent attention has turned to platelet-rich plasma (PRP) and hyaluronic acid (HA) injection therapies.ObjectiveThis meta-analysis aimed to evaluate the efficacy and safety of PRP combined with HA versus PRP alone in the treatment of KOA.MethodsWe conducted a comprehensive literature search of the PubMed, Embase, and Cochrane Library databases, which included covering publications from their inception to July 2024. Studies comparing PRP+HA with PRP alone were selected. Data on visual analog scale (VAS) scores, WOMAC total scores, Lequesne scores, and adverse events were extracted. Statistical analysis was performed via Review Manager 5.3.5.ResultThis meta-analysis included 16 studies involving a total of 1,384 patients. The VAS score comparison indicated that, in the long term, PRP combined with HA was more effective in reducing knee pain than PRP alone was (SMD: -0.30, 95% CI: -0.53 to -0.06, P = 0.01). The combined PRP and HA treatment achieved better results in terms of the WOMAC total score (MD = -6.58, 95% CI: -10.65 to -2.52, P ConclusionPRP combined with HA offers significant long-term benefits in pain relief and functional improvement over PRP alone for knee osteoarthritis, with better safety. The sequence of injection may influence treatment outcomes.Systematic review registrationPROSPERO CRD42024598691背景：膝骨关节炎（Knee osteoarthritis, KOA）是一类常见的退行性关节疾病，主要累及老年人群。传统治疗手段涵盖药物治疗与物理疗法，近年来富血小板血浆（platelet-rich plasma, PRP）与透明质酸（hyaluronic acid, HA）注射治疗逐渐成为研究热点。 目的：本荟萃分析旨在对比富血小板血浆联合透明质酸（PRP+HA）与单纯富血小板血浆（PRP）治疗膝骨关节炎的有效性与安全性。 方法：我们对PubMed、Embase及Cochrane Library数据库开展全面文献检索，检索时限为各数据库建库至2024年7月。纳入比较PRP联合HA与单纯PRP治疗KOA的相关研究，提取视觉模拟评分（visual analog scale, VAS）、WOMAC总分、Lequesne评分及不良事件相关数据。采用Review Manager 5.3.5软件完成统计学分析。 结果：本荟萃分析共纳入16项研究，涉及1384例患者。视觉模拟评分对比结果显示，长期随访中PRP联合HA较单纯PRP更能有效缓解膝关节疼痛（标准化均数差standardized mean difference, SMD=-0.30，95%置信区间95% confidence interval, 95%CI：-0.53~-0.06，P=0.01）。PRP联合HA治疗在WOMAC总分维度上亦取得更优结果（均数差mean difference, MD=-6.58，95%CI：-10.65~-2.52，P）。 结论：相较于单纯PRP治疗，PRP联合HA在膝骨关节炎的长期疼痛缓解与功能改善方面具有显著优势，且安全性更优。注射顺序可能会对治疗结局产生影响。 系统评价注册：PROSPERO CRD42024598691