{"id":2391,"date":"2023-08-16T11:39:00","date_gmt":"2023-08-16T02:39:00","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2391"},"modified":"2023-08-16T11:39:00","modified_gmt":"2023-08-16T02:39:00","slug":"%e8%86%9d%e5%a4%89%e5%bd%a2%e6%80%a7%e9%96%a2%e7%af%80%e7%97%87%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e3%83%92%e3%82%a2%e3%83%ab%e3%83%ad%e3%83%b3%e9%85%b8%e9%96%a2%e7%af%80%e6%b3%a8%e5%b0%84%e3%81%ae","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2391","title":{"rendered":"\u819d\u5909\u5f62\u6027\u95a2\u7bc0\u75c7\u306b\u5bfe\u3059\u308b\u30d2\u30a2\u30eb\u30ed\u30f3\u9178\u95a2\u7bc0\u6ce8\u5c04\u306e\u52b9\u679c\uff08SR\u3001\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff09"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nTiago V Pereira, Peter Ju\u0308ni, Pakeezah Saadat, et al. Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis BMJ 2022;378:e069722<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a
\n\u4e16\u754c\u4e2d\u30675\u5104\u4eba\u3092\u8d85\u3048\u308b\u4eba\u304c\u5909\u5f62\u6027\u819d\u95a2\u7bc0\u75c7(OA)\u306b\u7f79\u60a3\u3057\u3066\u3044\u308b\u3002\u30d2\u30a2\u30eb\u30ed\u30f3\u9178\u306e\u95a2\u7bc0\u6ce8\u5c04\uff08Viscosupplementation\uff09\u306f50\u5e74\u4ee5\u4e0a\u524d\u304b\u3089\u3088\u304f\u884c\u308f\u308c\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u6709\u52b9\u6027\u3084\u5b89\u5168\u6027\u306b\u3064\u3044\u3066\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002\u30a4\u30ae\u30ea\u30b9\u3067\u306f\u4e00\u90e8\u306e\u4eba\u306b\u884c\u308f\u308c\u3066\u3044\u308b\u304c\u3001\u30a2\u30e1\u30ea\u30ab\u3067\u306fMedicare\u306eOA\u60a3\u8005\u306e7\u4eba\u306b1\u4eba\u306f\u95a2\u7bc0\u6ce8\u5c04\u3092\u65bd\u884c\u3055\u308c\u3066\u3044\u308b\u3002\u3053\u306eSR\u3067\u306f\u819dOA\u306e\u9593\u63a5\u6ce8\u5c04\u306e\u81e8\u5e8a\u7684\u52b9\u679c\u3068\u5b89\u5168\u6027\u306b\u3064\u3044\u3066\u8abf\u3079\u308b\u3002
\nMethod\uff1a
\n\u3000PRISMA\u306b\u57fa\u3065\u304d\u3001PROSPERO\u306b\u767b\u9332\u3055\u308c\u305f\u4e0a\u3067\u884c\u308f\u308c\u305f\u3002
\n\u5bfe\u8c61\u8ad6\u6587\u306e\u9078\u629e\uff1bRCT\u3001quasiRCT\u306e\u307f\u5bfe\u8c61\u3002
\n\u75db\u307f\u3001\u6a5f\u80fd\u3001\u6709\u5bb3\u4e8b\u8c61\u306e\u3046\u3061\u5c11\u306a\u304f\u3068\u3082\u4e00\u3064\u3092\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3057\u3066\u3044\u308bOA\u306e\u4eba\u3092\u5bfe\u8c61\u3002
\n2021\u5e749\u670811\u65e5\u307e\u3067\u306e\u671f\u9593\u3067\u3001Medline\u3001Embase\u3001CENTRAL\u3092\u8a00\u8a9e\u5236\u9650\u306a\u3057\u3067\u691c\u7d22\u3002\u305d\u306e\u307b\u304b\u5b66\u4f4d\u8ad6\u6587\u3001\u500b\u4eba\u901a\u4fe1\u3001\u66f8\u7c4d\u3001\u30d1\u30f3\u30d5\u30ec\u30c3\u30c8\u3001\u5b66\u4f1a\u6284\u9332\u3001\u81e8\u5e8a\u8a66\u9a13\u767b\u9332\u3001\u30e1\u30fc\u30ab\u30fc\u306e\u5831\u544a\u66f8\u3001\u898f\u5236\u95a2\u9023\u6587\u66f8\u304b\u3089\u9069\u683c\u306a\u81e8\u5e8a\u8a66\u9a13\u3092\u7279\u5b9a\u3057\u305f\u3002\u691c\u7d22\u8a9e\u306fappendices\u53c2\u7167\u3002
\n\u8a55\u4fa1\u8005\uff1a8\u4eba\u4e2d2\u4eba\u305a\u3064\u30c7\u30fc\u30bf\u62bd\u51fa\u3001\u4e3b\u89e3\u6790\u306b\u95a2\u9023\u3059\u308b\u8a66\u9a13\u306b\u3064\u3044\u3066\u306fROB2.0\u306b\u57fa\u3065\u3044\u30662\u540d\u3067\u884c\u3063\u305f\u3002\u610f\u898b\u304c\u5206\u304b\u308c\u305f\u5834\u5408\u306f\u5354\u8b70\u3001\u3042\u308b\u3044\u306f3\u4eba\u76ee\u304c\u6c7a\u5b9a\u3002
\n\u3000\u30a2\u30a6\u30c8\u30ab\u30e0\uff1aprimary outcome\uff1a\u75db\u307f\u3000secondary outcome \u6a5f\u80fd\u3068\u6709\u5bb3\u4e8b\u8c61
\n\u8a55\u4fa1\u57fa\u6e96\u306fSMD(standardized mean difference)\u3067\u884c\u306a\u3063\u305f\u3002\u6700\u5c0f\u306e\u81e8\u5e8a\u7684\u610f\u7fa9\u306e\u3042\u308b\u5dee\u3092-0.37 (VAS 9mm)\u3068\u8a2d\u5b9a\u3002
\n\u7d71\u8a08\u89e3\u6790\u306fStata\u3068R\u3092\u7528\u3044\u305f\u3002random effect model\u3092\u89e3\u6790\u306b\u4f7f\u7528\u3002\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306ffannel plots\u3067\u8003\u616e\u3002
\n\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u306f\u4e21\u7fa4100\u4ee5\u4e0a\u306e\u7814\u7a76\u3092\u5bfe\u8c61\uff08small study effect\u3092\u8003\u616e\u3057\u3066\uff09<\/p>\n

\"\"<\/a><\/p>\n

\u4e0a\u8a18\u306e\u30d5\u30ed\u30fc\u306e\u901a\u308a\u3001169\u306e\u7814\u7a76 (21163\u4eba) \u304c\u5bfe\u8c61\u3068\u306a\u308a\u3001\u305d\u306e\u3046\u306124\u306e\u7814\u7a76 (8997\u4eba) \u304c\u4e3b\u89e3\u6790\u306e\u5bfe\u8c61\u3068\u306a\u3063\u305f\u3002<\/p>\n

25\u306e\u5bfe\u8c61\u8ad6\u6587\u306e\u4e00\u89a7
\n\"\"<\/a><\/p>\n

\u65e5\u672c\u306e\u8ad6\u6587\u306f1983\u5e74\u306b\u4e00\u3064\u306e\u307f\u3002\u51fa\u7248\u3055\u308c\u3066\u3044\u306a\u3044\u3082\u306e\u30825\u3064\u542b\u307e\u308c\u308b\u3002<\/p>\n

Primary Outcome
\n\"\"<\/a><\/p>\n

\u75db\u307f\u306f\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u5dee\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\uff08SMD-0.08 (95%CI -0.15 to -0.02)\uff09
\nVAS\u3067\u306f (-2mm (95% CI -3.8 to -0.5))
\n \u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u3067\u306f\u3001\u81e8\u5e8a\u7684\u610f\u7fa9\u3092\u8d85\u3048\u305f\u306e\u306f\u82f1\u8a9e\u4ee5\u5916\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u6e2c\u5b9a\u306b\u5927\u304d\u306a\u30d0\u30a4\u30a2\u30b9\u304c\u61f8\u5ff5\u3055\u308c\u308b\u7814\u7a76\u306e\u307f\u3060\u3063\u305f\u3002<\/p>\n

\"\"<\/a><\/p>\n

\u307e\u305f1983\u5e74\u306b\u51fa\u7248\u3055\u308c\u305f\u8ad6\u6587\u306e\u307f\u81e8\u5e8a\u7684\u6709\u610f\u3068\u306a\u308b\u304c\u3001\u305d\u306e\u5f8c\u306e\u5dee\u306f\u5c0f\u3055\u304f\u306a\u308a\u30012012\u5e74\u4ee5\u964d\u304b\u3089\u306f0.2\u306e\u540c\u7b49\u6027\u30de\u30fc\u30b8\u30f3\u306e\u4e2d\u306b\u5165\u3063\u3066\u3044\u308b (VAS 5mm)\u3002
\nSecondary outcome:\u6a5f\u80fd\u300019\u306e\u7814\u7a76\u304c\u5bfe\u8c61\u3068\u306a\u308a\u3001SMD\u306f-0.11 (95%CI -0.18 to -0.05)\u3060\u3063\u305f\u3002
\nSecondary outcome:\u6709\u5bb3\u4e8b\u8c61\u3000RR 1.49 ( 95%CI 1.12 to 1.98) \u95a2\u7bc0\u6ce8\u5c04\u7fa4\u304c3.7%\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f2.5%\u3060\u3063\u305f\u3002 <\/p>\n

Discussion\uff1a
\n\u3000\u672c\u7814\u7a76\u306e\u7d50\u679c\u3068\u3057\u3066\u306f\u3001\u95a2\u7bc0\u6ce8\u5c04\u306f\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u3066\u3001\u75db\u307f\u306e\u5f37\u3055\u306e\u308f\u305a\u304b\u306a\u6e1b\u5c11\u306b\u6709\u610f\u306b\u95a2\u9023\u3057\u3066\u3044\u305f\u304c\u3001\u305d\u306e\u5dee\u306f\u81e8\u5e8a\u7684\u306b\u91cd\u8981\u306a\u6700\u5c0f\u306e\u7fa4\u9593\u5dee\u672a\u6e80\u3067\u3042\u308a\u3001VAS5mm\u306e\u540c\u7b49\u6027\u30de\u30fc\u30b8\u30f3\u3092\u6301\u3063\u3066\u540c\u7b49\u3068\u3044\u3046\u7d50\u679c\u3067\u3042\u3063\u305f\u3002\u307e\u305f\u30d7\u30e9\u30bb\u30dc\u7fa4\u3068\u6bd4\u3079\u3066\u6709\u610f\u306a\u6709\u5bb3\u4e8b\u8c61\u306e\u5897\u52a0\u3092\u8a8d\u3081\u305f\u3002\u307e\u305f\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u9078\u629e\u7684\u306a\u5831\u544a\u304c\u3055\u308c\u3066\u3044\u305f\u3053\u3068\u3001\u4e0d\u5229\u306a\u7d50\u679c\u306e\u5831\u544a\u304c\u3055\u308c\u3066\u3044\u306a\u304b\u3063\u305f\u3053\u3068\u304c\u308f\u304b\u3063\u305f\u3002
\nStrength
\nOA\u306b\u5bfe\u3059\u308b\u30ec\u30d3\u30e5\u30fc\u3068\u3057\u3066\u306f\u6700\u5927\u3001\u4ee5\u524d\u306e\u3082\u306e\u3068\u6bd4\u8f03\u3059\u308b\u3068\u5305\u62ec\u7684\u30672\u500d\u306e\u8a66\u9a13\u6570\u3068\u306a\u3063\u3066\u3044\u308b\u3002
\n\u6700\u5c0f\u306e\u81e8\u5e8a\u7684\u610f\u7fa9\u306e\u3042\u308b\u5dee\u3092VAS9mm\u3068\u3057\u305f\u70b9\u306f\u5148\u884c\u7814\u7a76\u3068\u6bd4\u3079\u3066\u3082\u4fdd\u5b88\u7684\u3067\u3042\u308b\uff0820mm\u3068\u3057\u305f\u6587\u732e\u3082\u3042\u308a\uff09\u3002
\nLimitation
\n\u7d71\u5408\u3057\u305f\u7d50\u679c\u306a\u306e\u3067\u5bfe\u8c61\u3092\u7d5e\u308c\u3070\u3001\u6069\u6075\u3092\u53d7\u3051\u308b\u96c6\u56e3\u304c\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002
\n\u6709\u5bb3\u4e8b\u8c61\u306b\u5bfe\u3057\u3066\u6709\u610f\u5dee\u306f\u51fa\u305f\u304c\u3001\u6b63\u78ba\u306b\u306fIPDmeta\u3084\u3059\u3079\u3066\u306e\u6709\u5bb3\u4e8b\u8c61\u3092\u5206\u985e\u3057\u3066\u691c\u8a0e\u3057\u306a\u3051\u308c\u3070\u672c\u5f53\u306b\u95a2\u4fc2\u304c\u3042\u308b\u304b\u306f\u8a00\u3048\u306a\u3044\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112022\u5e749\u670814\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d Tiago V Pereira, Peter Ju\u0308ni, Pakeezah Saadat, et al. Viscosupplementation for knee osteoarthritis: syst … \u7d9a\u304d\u3092\u8aad\u3080 \u819d\u5909\u5f62\u6027\u95a2\u7bc0\u75c7\u306b\u5bfe\u3059\u308b\u30d2\u30a2\u30eb\u30ed\u30f3\u9178\u95a2\u7bc0\u6ce8\u5c04\u306e\u52b9\u679c\uff08SR\u3001\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff09<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,17],"tags":[],"class_list":["post-2391","post","type-post","status-publish","format-standard","hentry","category-23","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2391"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2391\/revisions"}],"predecessor-version":[{"id":2396,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2391\/revisions\/2396"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}