Intra-Articular Platelet-Rich Plasma Combined With Hyaluronic Acid Injection for Knee Osteoarthritis Is Superior to Platelet-Rich Plasma or Hyaluronic Acid Alone in Inhibiting Inflammation and Improving Pain and Function

Xu, Zhe; He, Zhaohui; Shu, Liping; Li, Xuanze; Ma, Minxian; Ye, Chuan

doi:10.1016/j.arthro.2020.10.013

Cited by 54 publications

(37 citation statements)

References 62 publications

(70 reference statements)

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“…In young adults (18–30 years of age) diagnosed with knee OA, intraarticular PRP therapy led to a statistically significant decrease in IL-1β, IL-6, TNFα, IL-17A, RANKL, and IFNγ levels ( Table 2 ) [ 163 ]. A study performed on eutrophic individuals (BMI between 22–25 kg/m 2 ) aged between 42 and 79 years comparing intraarticular PRP, HA, and the combination between PRP and HA found that IL-1β, TNFα, TIMP1, and MMP-3 values were diminished in the PRP group at 6 months posttreatment [ 164 ]. Nevertheless, the association of PRP and HA held the best results in reducing proinflammatory markers [ 164 ].…”

Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

“…A study performed on eutrophic individuals (BMI between 22–25 kg/m 2 ) aged between 42 and 79 years comparing intraarticular PRP, HA, and the combination between PRP and HA found that IL-1β, TNFα, TIMP1, and MMP-3 values were diminished in the PRP group at 6 months posttreatment [ 164 ]. Nevertheless, the association of PRP and HA held the best results in reducing proinflammatory markers [ 164 ].…”

Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

“…A recent research comparing the efficacy of intraarticular HA to ozone (O 3 ) found that both reduced joint stiffness in patients with knee OA [ 166 ]. Other published studies aimed to investigate the possible differences between intraarticular HA and biologics, PRP, or O 3 ( Table 3 ) [ 132 , 133 , 164 , 165 , 166 ]. Xu et al reported positive results for a PRP + HA combination with respect to the reduction in proinflammatory cytokine values and MMP-3 [ 164 ].…”

Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

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From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside

Rezuş

Burlui

Cardoneanu

et al. 2021

IJMS

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Osteoarthritis (OA) is currently the most widespread musculoskeletal condition and primarily affects weight-bearing joints such as the knees and hips. Importantly, knee OA remains a multifactorial whole-joint disease, the appearance and progression of which involves the alteration of articular cartilage as well as the synovium, subchondral bone, ligaments, and muscles through intricate pathomechanisms. Whereas it was initially depicted as a predominantly aging-related and mechanically driven condition given its clear association with old age, high body mass index (BMI), and joint malalignment, more recent research identified and described a plethora of further factors contributing to knee OA pathogenesis. However, the pathogenic intricacies between the molecular pathways involved in OA prompted the study of certain drugs for more than one therapeutic target (amelioration of cartilage and bone changes, and synovial inflammation). Most clinical studies regarding knee OA focus mainly on improvement in pain and joint function and thus do not provide sufficient evidence on the possible disease-modifying properties of the tested drugs. Currently, there is an unmet need for further research regarding OA pathogenesis as well as the introduction and exhaustive testing of potential disease-modifying pharmacotherapies in order to structure an effective treatment plan for these patients.

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Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

Section: Therapeutic Approach To Synovial Inflammation In Knee Ostmentioning

confidence: 99%

See 1 more Smart Citation

From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside

Rezuş

Burlui

Cardoneanu

et al. 2021

IJMS

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“…The blood was separated into 3 components: erythrocytes at the bottom, a buffy coat in the middle, and platelet containing plasma at the top. (34) (Medifuge MF200, Italy Silfdradent). The platelet-containing plasma was then aspirated and transferred to a new tube without anticoagulant and centrifuged at 250g for 15 minutes.…”

Section: Prp Preparationmentioning

confidence: 99%

Biochemical and Histological Evaluation of different intra-articular injections as therapy for Temporomandibular Joint Osteoarthritis in Rats

Arafat

Kamel

2021

Egyptian Dental Journal

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Introduction: Temporomandibular joint (TMJ) osteoarthritis is usually treated by intraarticular injection of medications. Intra-articular hyaluronic acid (HA) injection reduces friction and stress on the joint cartilage through lubrication, chondro-protection and proteoglycans synthesis. Platelet Rich Plasma (PRP) with its high concentration of growth factors plays a great role in joint repair through enhancing osteo-inductivity, and chondrogenic differentiation. This study aims at comparing intra-articular injection of combination of hyaluronic acid and platelet rich plasma to intra-articular injection of each of them alone.Materials and Methods: 24 young adult male 250-300 grams albino rats were used in the current study divided randomly into 4 groups: Group 1 (control) in which animals were left without treatment. Group 2 which was subdivided into 3 study groups, in Group 2A: the animals received 2 doses of HA, in Group 2B: the animals received 2 doses of PRP, and in Group 2C: the animals received 2 doses of combined PRP and HA. After 28 days, the animals were sacrificed and histological analysis was performed. Synovial fluid Samples were extracted before each intraarticular injection, the concentration of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) were detected and statistically analyzed.Results: Group 2C showed superior findings to the other 2 study groups regarding fibrocartilage and bone regeneration, while Group 2B was superior to group 2A regarding the study parameters. Conclusion:Intra-articular injection of combination of PRP and HA is superior to intraarticular injection of HA or PRP alone for the treatment of TMJ osteoarthritis in rats.

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“…Although appealing, the resulting clinical outcome may not be so obvious, and no additive effect should be taken for granted since what happens in vitro may not be mirrored in the more complex in vivo setting. 3 Although some attempts of combining platelet-rich plasma (PRP) and viscosupplementation have been performed in past years, 4 the study by Xu, He, Shu, Li, Ma, and Ye titled "Intra-Articular Platelet-Rich Plasma Combined With Hyaluronic Acid Injection for Knee Osteoarthritis Is Superior to Platelet-Rich Plasma or Hyaluronic Acid Alone in Inhibiting Inflammation and Improving Pain And Function" 5 deserves attention.…”

Section: See Related Article On Page 903mentioning

confidence: 99%

Editorial Commentary: Platelet-Rich Martini or Vodka Hyaluronate? The Dilemma of Drink Selection for the Modern Orthopaedic Surgeon

Matteo

Kon

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The number of options for intra-articular treatment of osteoarthritis has been growing over the years, and currently a wide range of injectables is available, from "traditional" products such as corticosteroids and hyaluronic acid (HA) to biologic agents like platelet-rich plasma (PRP) and mesenchymal stem cells. Although the ultimate goal is to exert a modulation on the intra-articular environment, these substances act through different mechanisms of action. The combination of different products may have a rationale in taking advantage of complementary actions, but the "additive" effect and the safety should be demonstrated before any recommendation of use. Recently, the combination of HA and PRP has been tested in some clinical trials, with outcomes apparently superior to those of HA and PRP alone. This strategy may open a new scenario for the future, provided that we put scientific evidence before the pressure of the market, especially when dealing with cell-based approaches, which, although very attractive for patients, still need solid data to support their use as injectables.

show abstract

Intra-Articular Platelet-Rich Plasma Combined With Hyaluronic Acid Injection for Knee Osteoarthritis Is Superior to Platelet-Rich Plasma or Hyaluronic Acid Alone in Inhibiting Inflammation and Improving Pain and Function

Cited by 54 publications

References 62 publications

From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside

From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside

Biochemical and Histological Evaluation of different intra-articular injections as therapy for Temporomandibular Joint Osteoarthritis in Rats

Editorial Commentary: Platelet-Rich Martini or Vodka Hyaluronate? The Dilemma of Drink Selection for the Modern Orthopaedic Surgeon

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