Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial

Nouri, Farshad; Babaee, Marzieh; Peydayesh, Parya; Esmaily, Hadi; Raeissadat, Seyed Ahmad

doi:10.1186/s12891-022-05787-8

Cited by 20 publications

(25 citation statements)

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“…Out of the seven studies examined, four of them found no incidences of adverse effects or complications in patients who had intra-articular injection treatments with PRP or HA [ 21 , 22 , 24 , 26 ]. In three studies, patients reported experiencing post-injection pain which was consistently higher in the PRP group, of a temporary nature, and resolved on its own [ 20 , 23 , 25 ]. One study noted 10 pain reactions in the PRP group versus six in HA group [ 20 ].…”

Section: Reviewmentioning

confidence: 99%

“…In the second study, PRP participants experienced a significantly higher pain reaction than the HA group [ 23 ]. In the third study, there was a significantly higher incidence of pain during or after injection in the PRP group (3.50±2.22) versus the HA group (3.22±2.40) [ 25 ]. One study documented an isolated occurrence of a superficial hematoma that spontaneously resolved [ 20 ].…”

Section: Reviewmentioning

confidence: 99%

“…One study documented an isolated occurrence of a superficial hematoma that spontaneously resolved [ 20 ]. Another study noted temporary warmness, stiffness, and heaviness [ 25 ]. Table 3 outlines the adverse events and complications identified in the respective studies.…”

Section: Reviewmentioning

confidence: 99%

“…Our review demonstrated that post-injection pain was persistently more prominent in the PRP group in three studies [ 20 , 23 , 25 ]. This may have been influenced by PRP preparation techniques or needle choice.…”

Section: Reviewmentioning

confidence: 99%

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Comparing Intra-articular Platelet-Rich Plasma With Hyaluronic Acid for the Treatment of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Sambe,

Yasir,

Man

et al. 2023

Cureus

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Hip osteoarthritis (HOA), a prevalent condition among those aged 55 years and above, is a significant cause of joint pain and functional impairment and it contributes to the overall burden of chronic pain experienced by the elderly population. While platelet-rich plasma (PRP) and hyaluronic acid (HA) injections have emerged as innovative therapeutic approaches for managing osteoarthritis, their effectiveness in HOA remains a subject of contention. Therefore, the objective of this review was to assess the efficacy of PRP versus HA in terms of pain relief and functional outcomes for the management of HOA. We searched PubMed, Cochrane Library, and Google Scholar databases from 2013 to 2023 to identify pertinent randomized controlled trials (RCTs). A total of seven trials (478 participants) were included. The selected studies underwent quality assessment using the updated Cochrane risk of bias tool. The pain and functional outcomes were examined using measures of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, visual analog scale (VAS), and Harris hip score (HHS). In the meta-analysis, standard mean differences (SMDs) along with 95% confidence intervals (CIs) to estimate overall effect magnitudes for continuous outcomes were extracted. Statistical significance was determined using p-values below 0.05. At six months, the PRP group experienced a significantly lower standard mean WOMAC pain score (SMD = -0.38, CI = -0.64 - 0.13; p = 0.03). No significant differences in WOMAC pain scores were noted at one to two months (SMD = 0.09, CI = -0.24, 0.43; p = 0.59), and at 12 months (SMD = -0.85, CI = -1.81, 0.12; p = 0.09). Similarly, for VAS, patients on PRP showed a slight improvement in their VAS scores at six months (SMD = -0.50, CI = -0.89, -0.12; p < 0.01). However, no significant differences in VAS between the PRP groups and the HA groups were observed at one to two months (SMD = -0.22, CI = -0.49, 0.04; p = 0.10) and at 12 months (SMD = -0.22, CI: -0.63, 0.19; p = 0.29). In terms of hip dysfunction, there was no statistically significant standard mean difference in HHS between the PRP and HA groups at six months (SMD = 0.02, CI = -0.40, 0.44; p = 0.93), and at 12 months (SMD = -0.31, CI = -0.32, 0.22; p = 0.73). This review and meta-analysis provide insights into emerging treatments for HOA, especially considering that PRP shows potential benefits and safety for patients with HOA during mid-term follow-up in a 12-month period. Nevertheless, it is necessary to conduct research that includes high-quality designs and larger sample sizes to validate the comparative efficacy of these treatments.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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Comparing Intra-articular Platelet-Rich Plasma With Hyaluronic Acid for the Treatment of Hip Osteoarthritis: A Systematic Review and Meta-Analysis

Sambe,

Yasir,

Man

et al. 2023

Cureus

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“…15,16 Some studies have proposed that treating hip OA with combinations of IA injections offers better results. Nouri et al 17 found that composite injection of PRP+HA showed improvement in pain and function sustained for more than six months. However, Dallari et al 15 reported that PRP+HA did not significantly improve pain symptoms at 12 months' follow-up.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of multiple intra-articular injection for hip osteoarthritis

Lei,

Wang,

et al. 2024

Bone Joint J

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AimsIntra-articular (IA) injection may be used when treating hip osteoarthritis (OA). Common injections include steroids, hyaluronic acid (HA), local anaesthetic, and platelet-rich plasma (PRP). Network meta-analysis allows for comparisons between two or more treatment groups and uses direct and indirect comparisons between interventions. This network meta-analysis aims to compare the efficacy of various IA injections used in the management of hip OA with a follow-up of up to six months.MethodsThis systematic review and network meta-analysis used a Bayesian random-effects model to evaluate the direct and indirect comparisons among all treatment options. PubMed, Web of Science, Clinicaltrial.gov, EMBASE, MEDLINE, and the Cochrane Library were searched from inception to February 2023. Randomized controlled trials (RCTs) which evaluate the efficacy of HA, PRP, local anaesthetic, steroid, steroid+anaesthetic, HA+PRP, and physiological saline injection as a placebo, for patients with hip OA were included.ResultsIn this meta-analysis of 16 RCTs with a total of 1,735 participants, steroid injection was found to be significantly more effective than placebo injection on reported pain at three months, but no significant difference was observed at six months. Furthermore, steroid injection was considerably more effective than placebo injection for functional outcomes at three months, while the combination of HA+PRP injection was substantially more effective at six months.ConclusionEvidence suggests that steroid injection is more effective than saline injection for the treatment of hip joint pain, and restoration of functional outcomes.Cite this article: Bone Joint J 2024;106-B(6):532–539.

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