Treatment of knee osteoarthritis with platelet-rich plasma plus hyaluronic acid in comparison with platelet-rich plasma only
Background: The exact outcome of the combined use of hyaluronic acid (HA) and platelet-rich plasma (PRP) in the treatment for osteoarthritis remains unclear. The goal of this paper was to compare the efficacy of PRP + HA with those of a cohort of patients treated with platelet-rich plasma only. Materials and methods: A total of 126 Subjects with knee osteoarthritis were enrolled: 63 cases in PRP plus HA group and 63 cases in PRP group. After clinical and radiographic evaluation, patients received a weekly intra-articular injection of HA added with PRP or of only PRP for 3 weeks. Follow-up was carried out at 1, 3, 6, and 12 months. Results: In the participants treated with PRP plus HA and with PRP only, VAS scores decreased significantly, and accordingly, knee function (WOMAC) improved, compared to the status of patients prior to treatment. Regarding to VAS and WOMAC, no significant difference were observed between the two groups; however, there is a trend that could obtain better functional scores in PRP plus HA group (VAS, P = 0.392; WOMAC, P = 0.082). Six failures occurred in the PRP plus HA group and 11 in PRP group. No major adverse events or complications were observed in both groups. Conclusions: The association of PRP and HA is effective and safe in the management of patients suffering from mild to moderate KOA. Although no differences in functional outcomes were shown between the groups, there is a trend that PRP plus HA could obtain relatively better functional scores.