PRP may improve clinical outcomes of knee OA better than hyaluronic acid
Patients with knee osteoarthritis treated with platelet-rich plasma injections may have improved clinical outcomes compared with patients who received hyaluronic acid injections, according to published results.
Searching PubMed, the Cochrane Library and Embase, John W. Belk, BA, and colleagues identified 18 level 1 studies that compared the clinical efficacy of PRP (n=811) and hyaluronic acid (n=797) injections for knee OA. Researchers collected WOMAC, VAS for pain and subjective IKDC scale scores for patients in these studies and performed a subanalysis to isolate results from patients who received leukocyte-poor and leukocyte-rich PRP.
Results showed the PRP group had a mean improvement in WOMAC total score of 44.7% vs. 12.6% in the hyaluronic acid group. Researchers found six of 11 studies based on the VAS reported significantly less pain at latest follow-up among patients who received PRP compared with patients who received hyaluronic acid. Patients who received PRP also had significantly better subjective IKDC outcome scores reported by three of six studies, according to results. Researchers noted an association between significantly better subjective IKDC scores and leukocyte-poor PRP.
“For patients with knee osteoarthritis who are not yet at the stage of joint replacement consideration and are trying to manage conservatively, PRP is a superior treatment option over hyaluronic acid. It has been clearly demonstrated to reduce pain and improve patient-reported outcomes at a significantly higher rate, which should be heavily considered when deciding on a conservative course of management,” Belk told Healio Orthopedics. “As it stands right now, only hyaluronic acid is approved by insurance companies as a viable way to treat early knee osteoarthritis. Hopefully, this article will better inform patients, physicians and also insurance companies about the most effective ways to conservatively treat early knee osteoarthritis.”