Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis

Chen, Zehan; Wang, Chang; You, Di; Zhao, Shuhong; Zhu, Zhe; Xu, Meng

doi:10.1097/md.0000000000019388

Cited by 54 publications

(50 citation statements)

References 32 publications

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“…Furthermore, various studies were also done comparing the result and efficacy of PRP administration to HA which concluded that autologous PRP injections showed more and longer efficacy than HA injections in reducing pain and symptoms as well as in restoring articular function. Moreover, it is considered more effective and safer in the treatment of the initial stages of knee osteoarthritis than any other treatment approach, making it the most superior conservative treatment to date [ 19 ]. Meanwhile, different studies compared between intra-articular injection of PRP, HA, saline and placebo reported that intra-articular PRP injections have more benefit in pain relief and functional improvement in patients with symptomatic knee OA up to one-year post-injection [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study

Hegaze

Hamdi

Alqrache

et al. 2021

Cureus

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Background Osteoarthritis (OA) is a degenerative disease commonly affecting the knee joints. It affects patients socially, psychologically and economically and rates of the disease have been increasing due to obesity and old age. Regardless of choosing a medically conservative approach, it is a challenge in the long term to provide OA patients efficient treatment with minimal side effects and long-term efficiency. Platelet-rich plasma (PRP) is a convenient, low-cost and affordable treatment technique used in treating knee OA with encouraging efficient and safe outcomes. In this study we will investigate the effect of PRP on knee OA. Methods This is a prospective cohort study involving 252 patients with different OA grades. The Kellgren and Lawrence (K&L) system was used in classifying the affected knee by degenerative cartilage lesions as well as early and severe OA. All patients with a diagnosis of knee OA were screened in every visit before the injection, the pain was assessed by the 0-10 Numeric Rating Scale (NRS), and knee range of motion including flexion and extension was assessed by goniometer. Follow-up appointments were done on three-month intervals for a total of three visits for evaluation. Injection of PRP was given to all the patients with a maximum of four injections. The results were evaluated statistically according to the total number of followup visits. Results In grade II patients, the pain improved with the visits and the maximum improvement in flexion degree was noticed in patients who came for a total of three follow-up visits. In grade III patients, the most improvement in pain was in patients who came for three follow-up visits, while the most improvement in flexion degree was in patients who came for a total of two follow-up visits. Patients with grade IV who came for three follow-up visits showed the most improvement in pain and degree of flexion. Conclusions Intra-articular injections gave significant pain and flexion improvement in grades II, III and IV in OA patients, especially with multiple injection in the short-term follow-up. As a result, recommendation of repeated multiple injections up to four times is efficient in providing long time relief in knee OA.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study

Hegaze

Hamdi

Alqrache

et al. 2021

Cureus

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“…This is the first network meta-analysis using the Bayesian method simultaneously comparing the efficacy and safety of MSCs, PRP, HA, and GCs. As mentioned above, many [42,43] have evaluated the efficacy of different intra-articular injection agents in the treatment of osteoarthritis, but most of these studies incorrectly took scale scores at different follow-up stages as outcome measures, ignoring the heterogeneities between the baseline scores of cohorts in different trials and how they affect the results. This is the reason we used the changes from baseline scores as the outcome measures in this study.…”

Section: Discussionmentioning

confidence: 99%

Mesenchymal Stem Cells: A New Choice for Nonsurgical Treatment of OA? Results from a Bayesian Network Meta-Analysis

Cao

Gao

et al. 2021

BioMed Research International

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Objective. Osteoarthritis (OA) is the most common degenerative joint disease, causing joint pain, stiffness, and even disability. Guidelines recommend intra-articular injections as an alternative treatment to relieve OA symptoms for patients who demonstrate poor tolerability or compliance to oral administration of drugs. Mesenchymal stem cells (MSCs) are a potential treatment for of OA. We conducted this network meta-analysis to comprehensively compare the efficacy and safety between hyaluronic acid (HA), corticosteroids (GCs), platelet-rich plasma (PRP), and MSCs. Design. Systematic review and Bayesian network meta-analysis. Data Sources. Relevant studies, published from January 2000 to January 2020, in the PubMed, Cochrane library, EMBASE, and CKNI databases. Methods. Bayesian network and conventional meta-analyses were conducted. Pain relief, functional improvement, improvement in joint stiffness, and risk of adverse effects (AEs) were assessed. Results. Twenty-five articles with 4642 patients were included. Overall, MSC therapy was the most effective treatment for pain relief (standardized mean difference compared with placebo = 3.61 , 95% CI [1.87 to 5.35]). Both MSC and PRP therapies improved every symptom of OA effectively and have an advantage over HA and GCs which are recommended by guidelines. MSCs, PRP, HA, and GCs are tolerated well for patients in long-term treatment of OA compared with placebo. Conclusions. The results show that MSCs relieve pain, stiffness, and dysfunction due to OA better than PRP, HA, and GCs and are not statistically correlated with greater safety concerns. More high-quality trials are needed to reconfirm the findings of this study, however, standardization of preparation of MSCs and PRP should be investigated in the future.

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“…However, the same study found no differences between groups when analyzing fractional WOMAC scores for stiffness and physical function. 16 Another meta-analysis demonstrated the superiority of PRP over HA in pain improvement as assessed by the WOMAC score. However, the study concluded that there is no obvious superiority between PRP and HA in knee OA treatment.…”

Section: Discussionmentioning

confidence: 99%

Infiltração intraarticular de plasma rico em plaquetas versus ácido hialurônico em pacientes com osteoartrose primária do joelho: Ensaio clínico randomizado com resultados preliminares

Arliani

Durigon

Pedroso

et al. 2021

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Comparar o efeito da infiltração intraarticular do plasma rico em plaqueta com a do ácido hialurônico no tratamento de pacientes com osteoartrose primária de joelho. Métodos Realizou-se um ensaio clínico randomizado com 29 pacientes, sendo um grupo submetido à infiltração com ácido hialurônico (controle) e o outro com plasma rico em plaquetas. Os desfechos clínicos avaliados foram a escala visual analógica da dor; o questionário Western Ontario and McMaster Universities Arthritis Index (WOMAC), antes e depois da intervenção; e os efeitos adversos após as aplicações. Utilizou-se os testes do qui-quadrado e exato de Fisher para as variáveis categóricas, e o teste t de Student, análise de variância, e Wilcoxon para as variáveis contínuas, através do software de estatística R. Resultados A análise independente de cada grupo revelou uma diferença estatística nos meses iniciais, com melhora dos escores de dor e função; porém, com piora no 6° mês após o procedimento. Não houve diferença dos desfechos avaliados entre os grupos que foram submetidos à infiltração com ácido hialurônico ou com plasma rico em plaquetas. Não houve efeito adverso grave ou reação alérgica durante todo o seguimento. Conclusão A infiltração intraarticular com ácido hialurônico ou plasma rico em plaquetas nos joelhos dos pacientes com gonartrose primária apresentou melhora temporária dos sintomas de função e dor. Não houve diferença entre as duas intervenções.

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Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis

Cited by 54 publications

References 32 publications

Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study

Efficacy of Platelet-Rich Plasma on Pain and Function in the Treatment of Knee Osteoarthritis: A Prospective Cohort Study

Mesenchymal Stem Cells: A New Choice for Nonsurgical Treatment of OA? Results from a Bayesian Network Meta-Analysis

Infiltração intraarticular de plasma rico em plaquetas versus ácido hialurônico em pacientes com osteoartrose primária do joelho: Ensaio clínico randomizado com resultados preliminares

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