Sex differences in intra‐articular treatment outcomes for knee osteoarthritis
current evidence and research gaps: a systematic review and meta‐analysis
Informazioni aggiuntive
Autori
Fattini Fellini G.,
Fumagalli G. A.,
Piano A.,
Bensa A.,
Filardo G.
Tipo
Articolo pubblicato in rivista scientifica
Anno
2025
Lingua
Inglese
Sommario
Purpose: The aim of this systematic review and meta-analysis was to quantify and compare the evidence on sex-specific outcomes following intra-articular injections of corticosteroids (CS), hyaluronic acid (HA), platelet-rich plasma (PRP) and cell-based therapies in patients affected by knee osteoarthritis (OA). Methods: A literature search was conducted on PubMed, Cochrane and Web of Science in October 2024 according to PRISMA guidelines. Inclusion criteria were clinical studies of any level of evidence, a minimum of six patients, English language, no time limitations, on the use of intra-articular CS, HA, PRP and cell-based therapies for knee OA treatment. A meta-analysis was conducted for each product on the outcomes with sufficient data at short-term (<3 months) and mid/long-term (≥3 months) follow-ups. Results: A total of 848 studies were included reporting on 99,443 patients (61.5 ± 24.7 years old, 65.8% women, 34.2% men). Out of these, only 21 articles (2.5% of the total, 2265 patients) presented sex-disaggregated data, including four studies with a CS treatment group (1.9% of CS patients), three with a HA group (0.2% of HA patients), 11 with a PRP group (5.9% of PRP patients) and eight with a cell-based therapy group (10.2% of cell-based therapies patients). The meta-analysis was performed on 15 studies (1387 patients) and did not show any statistically significant difference of VAS and WOMAC improvements at short- and mid/long-term follow-ups for any of the four injectable treatment approaches analysed. Conclusion: There is a staggering lack of sex-disaggregated data in studies evaluating the most used intra-articular injective therapies for knee OA, with only 2.5% analysing women- and men-specific outcomes for CS, HA PRP and cell-based therapies. The analysis of this limited amount of sex-disaggregated data did not show statistically significant differences between women and men for any of the investigated injectable approaches. The substantial lack of disaggregation hinders the understanding of potential sex-specific effects of these treatments and underscores the need for a shift in data reporting in this field, with more robustly designed studies incorporating sex-stratified analyses. Level of Evidence: Level I.
Parole chiave
Gender, Intra‐articular, Knee, Osteoarthritis, Sex
Periodico
Journal of Experimental Orthopaedics
Volume
12
Numero ( Mese )
3
Pagine (o numero dell’articolo)
e70432
ISSN
2197-1153
Diffusione
Licenza
Licenza non definita
Visibilità
Pubblico
