PLos One:非骨关节炎膝关节疼痛治疗的成本效益分析

2018-12-27 xiangting MedSci原创

没有足够的证据可以准确概述非骨关节炎膝关节疼痛治疗的成本效益,但急性ACL损伤的手术治疗似乎更具成本—效益。

膝关节疼痛在青少年和成人中很常见,并与进展为膝关节骨关节炎的风险升高相关。这项系统评价的目的是收集和评价不同非骨关节炎膝关节疼痛治疗方法的成本效益。

根据PRISMA指南进行系统评价,并在PROSPERO(CRD42016050683)上进行注册。通过PubMed在MEDLINE、EMBASE、Cochrane图书馆和国家医疗服务经济评估数据库进行文献检索。由两名独立评审员进行研究选择,并使用定制的提取表格提取数据。使用"健康经济标准共识"清单评估研究质量。

纳入15项研究。大多数是治疗前交叉韧带(ACL)损伤,但也发现了评估其他膝关节疼痛状况的研究,如半月板损伤、软骨缺损和髌股疼痛综合征。治疗被分类为手术性或非手术性治疗。手术治疗包括ACL重建、软骨细胞移植、半月板支架手术、半月板异体移植、部分半月板切除术、微骨折和不同类型的自体移植物和异体移植物。非手术治疗包括物理治疗、康复、运动、咨询、支撑和建议。一般而言,对于ACL损伤,单独进行手术治疗或与康复结合更具成本-效益。经济评估的质量为中等至高质量。

没有足够的证据可以准确概述非骨关节炎膝关节疼痛治疗的成本效益,但急性ACL损伤的手术治疗似乎更具成本-效益。关于非创伤性膝关节病变非手术治疗成本-效益的数据非常少。

原始出处:

Tamana Afzali. Cost-effectiveness of treatments for non-osteoarthritic knee pain conditions: A systematic review.  PLos One. 19 December 2018.

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    2019-04-18 lisa438
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1986825, encodeId=6f191986825c3, content=<a href='/topic/show?id=6b393012106' target=_blank style='color:#2F92EE;'>#关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30121, encryptionId=6b393012106, topicName=关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jan 13 12:07:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928901, encodeId=b3d0192890126, content=<a href='/topic/show?id=3c6e8586939' target=_blank style='color:#2F92EE;'>#膝关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85869, encryptionId=3c6e8586939, topicName=膝关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Sat Oct 12 18:07:00 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026610, encodeId=b77b2026610de, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Thu Apr 18 14:07:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1927367, encodeId=4421192e367c4, content=<a href='/topic/show?id=42fbe0602ff' target=_blank style='color:#2F92EE;'>#疼痛治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70602, encryptionId=42fbe0602ff, topicName=疼痛治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=583c133, createdName=yuandd, createdTime=Thu Nov 21 01:07:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1790313, encodeId=dbd71e90313df, content=<a href='/topic/show?id=6e4814388e2' target=_blank style='color:#2F92EE;'>#Plos one#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14388, encryptionId=6e4814388e2, topicName=Plos one)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fda6311, createdName=119337457, createdTime=Sun Nov 03 16:07:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265876, encodeId=942812658e629, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359878, encodeId=459e13598e8a3, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=356553, encodeId=464a35655382, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Thu Dec 27 20:31:24 CST 2018, time=2018-12-27, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1986825, encodeId=6f191986825c3, content=<a href='/topic/show?id=6b393012106' target=_blank style='color:#2F92EE;'>#关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30121, encryptionId=6b393012106, topicName=关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jan 13 12:07:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928901, encodeId=b3d0192890126, content=<a href='/topic/show?id=3c6e8586939' target=_blank style='color:#2F92EE;'>#膝关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85869, encryptionId=3c6e8586939, topicName=膝关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Sat Oct 12 18:07:00 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026610, encodeId=b77b2026610de, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Thu Apr 18 14:07:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1927367, encodeId=4421192e367c4, content=<a href='/topic/show?id=42fbe0602ff' target=_blank style='color:#2F92EE;'>#疼痛治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70602, encryptionId=42fbe0602ff, topicName=疼痛治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=583c133, createdName=yuandd, createdTime=Thu Nov 21 01:07:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1790313, encodeId=dbd71e90313df, content=<a href='/topic/show?id=6e4814388e2' target=_blank style='color:#2F92EE;'>#Plos one#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14388, encryptionId=6e4814388e2, topicName=Plos one)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fda6311, createdName=119337457, createdTime=Sun Nov 03 16:07:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265876, encodeId=942812658e629, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359878, encodeId=459e13598e8a3, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=356553, encodeId=464a35655382, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Thu Dec 27 20:31:24 CST 2018, time=2018-12-27, status=1, ipAttribution=)]
    2018-12-29 lmm397
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  8. [GetPortalCommentsPageByObjectIdResponse(id=1986825, encodeId=6f191986825c3, content=<a href='/topic/show?id=6b393012106' target=_blank style='color:#2F92EE;'>#关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30121, encryptionId=6b393012106, topicName=关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jan 13 12:07:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928901, encodeId=b3d0192890126, content=<a href='/topic/show?id=3c6e8586939' target=_blank style='color:#2F92EE;'>#膝关节疼痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85869, encryptionId=3c6e8586939, topicName=膝关节疼痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Sat Oct 12 18:07:00 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026610, encodeId=b77b2026610de, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Thu Apr 18 14:07:00 CST 2019, time=2019-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1927367, encodeId=4421192e367c4, content=<a href='/topic/show?id=42fbe0602ff' target=_blank style='color:#2F92EE;'>#疼痛治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70602, encryptionId=42fbe0602ff, topicName=疼痛治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=583c133, createdName=yuandd, createdTime=Thu Nov 21 01:07:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1790313, encodeId=dbd71e90313df, content=<a href='/topic/show?id=6e4814388e2' target=_blank style='color:#2F92EE;'>#Plos one#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14388, encryptionId=6e4814388e2, topicName=Plos one)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fda6311, createdName=119337457, createdTime=Sun Nov 03 16:07:00 CST 2019, time=2019-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265876, encodeId=942812658e629, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359878, encodeId=459e13598e8a3, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 29 06:07:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=356553, encodeId=464a35655382, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Thu Dec 27 20:31:24 CST 2018, time=2018-12-27, status=1, ipAttribution=)]
    2018-12-27 医者仁心5538

    学习了

    0

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膝关节疼痛,你想知道的都在这里。

JAMA: 针灸对于膝关节疼痛无改善作用

研究意义:目前针灸对于膝关节疼痛的治疗作用存在广泛争论。目的:测定激光针灸和传统针灸对慢性膝关节痛的治疗作用。方法:从2010年2月到2012年12月,研究者在澳大利亚维多利亚州采用Zelen 设计进行临床实验(即在知情同意之前进行随机分组)。实验征集了282个志愿者(年龄≥50,具有慢性膝关节痛),由家庭针灸师对志愿者进行治疗。实验分为4组:未进行针灸组(对照组,n=71),传统针灸组(n=70

JAMA:针灸治疗膝关节疼痛的争鸣,是否确有疗效?

《美国医学会杂志》10日发表来自5个国家8名学者的5封“致编辑的信”,就该刊发表的一篇关于针灸治疗关节疼痛随机临床试验报告提出不同意见,同时原始论文发表认为针灸无效的作者Hinman RS等也给予了回复。多家美国主流媒体和网站发表了相关消息和评论。(相关资料:JAMA: 针灸对于膝关节疼痛无改善作用 )5封信来自美国、中国、新西兰、瑞士和德国,从不同角度对针灸治疗膝关节疼痛无效的结论提出