Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

Abstract

Background. Knee osteoarthritis is a common disease with increasing incidence and prevalence in western countries. It can cause severe pain and functional limitations, thereby representing a threat for patients’ quality of life and a burden for national health systems. Intra-articular injections with hyaluronic acid (HA) and platelet-rich plasma (PRP) have been used for decades in order to reduce the symptoms caused by osteoarthritis. In recent years, a combination of HA and PRP has been introduced in clinical practice with the aim to minimize the clinical presentation of osteoarthritis and potentially delay articular degeneration. Materials and Methods. Sixty cases with grade II-III knee osteoarthritis according to the Kellgren–Lawrence classification were included in a prospective study, focused on the evaluation of clinical and functional outcomes after intra-articular knee injections. Cases were randomly divided into three groups. Twenty cases (Group A) were injected with HA, 20 (Group B) had PRP, and the remaining 20 (Group C) received a combination of HA and PRP. Basal WOMAC score and VAS score were recorded before the treatment and repeated within 3 and 6 months after the treatment. Results. At 6-month follow-up, Group C (PRP + HA) was the one with the lowest WOMAC and VAS mean values. It was also the only group that reported a reduction in the two values both in the first three months and in the following three months. No major complication was recorded. Conclusion. The combination of platelet-rich plasma and hyaluronic acid can be effective in the treatment of grade II-III knee osteoarthritis in a short-to-mid-term scenario. It represents an innovative and valuable alternative to the administration of its two components alone.

In Knee OA, Adding Hyaluronic Acid (HA) Vs. Cross-Linked HA to Intra-Articular Platelet-Rich Plasma Did Not Differ for Pain at 6 Months

“…The trial provides reasonable-quality evidence that PRP and HA treatment is an effective treatment option for patients with moderate OA of the knee (Kellgren-Lawrence grade 2), aligning with the results of Ciapini et al of favorable outcomes for 6 months after PRP plus HA treatment 1 . It does not, however, provide any insights as to whether combined treatment with PRP and HA is more effective than either of these treatments alone.…”

Enhancing Pain Relief in Temporomandibular Joint Arthrocentesis: Platelet-Rich Plasma and Hyaluronic Acid Synergy

“…This personalized treatment approach considers factors such as the severity of the condition, the patient's medical history, and specific pain patterns. This tailoring ensures the therapy is optimized for each patient, potentially yielding more effective pain relief and functional improvement [ 40 ].…”

Combination of Platelet-Rich Plasma and Hyaluronic Acid vs. Platelet-Rich Plasma Alone for Treatment of Knee Osteoarthritis

“…In this editorial, we focused on a recently published prospective clinical study by Ciapini et al [7], titled "Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study".…”