Comparative study between intra-articular injections of hyaluronic acid with platelet-rich plasma versus genicular nerve thermal radiation in management of pain in knee osteoarthritis

Abstract

ABSTRACT Background There are many factors affecting knee osteoarthritis (OA) as genetic and metabolic factors, obesity, mechanical trauma, osteoporosis, inflammatory joint disorders, previous joint infection, and laxity of ligaments. Objectives The aim of this study was to detect the influence of intra-articular injection (IAI) of both hyaluronic acid (HA) with platelet-rich plasma (PRP) and radiofrequency (RF) of genicular nerve and to compare their effects in the treatment of knee OA pain. Subjects and methods After approval of local research committee of anesthesia, Tanta University (committee protocol code 32049/01/18) and written informed consent, this prospective randomized study was done at Tanta University Hospital on 100 patients complaining of knees OA with mild-to-moderate degrees. IAI was performed in a pain clinic and RF was performed in an operating room during the period from April 2018 to January 2019. Results In intra-articular knee injection group, results show decreased visual analog scale (VAS) score from (3–10) at 1-week follow-up session to (0–8) in 6-month follow-up session. It also shows reduction of analgesia requirements (etoricoxib 60 and 90 mg) from (60–270) to (0–180) mg/day. In RF group patients, results show decreased VAS score from (0–9) at 1-week follow-up session to (0–5) in 6-month follow-up session. It also shows reduction of analgesia requirements (etoricoxib 60 and 90 mg) from (0–270) to (0–90) mg/day. Conclusion Both IAI of PRP with HA and RF of genicular nerves reduced pain of knee OA and reduced analgesic requirements with rapid onset in RF group.