Abstract
Background Knee osteoarthritis (KOA) is a common disease in aged adults. Intra-articular (IA) injection of platelet-rich plasma (PRP) therapy is an effective minimally invasive treatment for KOA. We aimed to compare the efficacy and safety of platelet-rich plasma (PRP) with placebo or other conservative treatments. Methods We conducted a meta-analysis to identify relevant articles from online register databases such as PubMed, Medline, Embase, and the Cochrane Library. The primary outcomes were the visual analogue scale (VAS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and International Knee Documentation Committee (IKDC) subjective score. The secondary outcome was the adverse event rate. Results A total of 895 articles were identified, of which 23 randomized controlled trials that met the inclusion criteria were determined as eligible. Compared with placebo, PRP had a lower VAS score and higher IKDC subjective score at the 6th month after treatment and significantly less WOMAC score during the follow-up period. Compared with oral NSAIDs, PRP gained a lower WOMAC score at the 6th month after treatment. The VAS score decreased after treatment when reaching PRP and CS. As compared to the HA, the VAS score, WOMAC score, and IKDC subjective score all revealed better PRP results. There were no significant differences in adverse event rates comparing PRP versus placebo or HA. Different PRP applications did not show significant differences in VAS score in the 1st month and WOMAC score in the 3rd month after treatment. Conclusion To compare with the conservative treatments mentioned above, PRP is more effective in relieving symptoms. There were no significant differences between triple PRP application and single PRP application in short-term curative effect.
Highlights
Knee osteoarthritis is prevalent globally among the aged adults with an ageing and increasingly obese population [1]
There were no significant differences between the two groups on visual analogue scale (VAS) score at 1st month after treatment (MD = −1:59, 95% confidence intervals (CI): -4.91 to 1.74; P = 0:35; Figure 5) and WOMAC score at 3rd month after treatment (MD = −12:75, 95% CI: -27.55 to 1.74; P = 2:05; Figure 5)
In our meta-analysis, we found that there were no significant differences between the platelet-rich plasma (PRP) group and the HA group at 1st month after treatment in VAS score, WOMAC score, and International Knee Documentation Committee (IKDC) subjective score, but the PRP group gained a lower VAS score at 12th month during the follow-up and lower WOMAC score at 6th month and 12th month after the treatment
Summary
Knee osteoarthritis is prevalent globally among the aged adults with an ageing and increasingly obese population [1]. Arthroplasty surgery is a clinically relevant and cost-effective treatment for endstage KOA. It can only be considered costeffective if the procedure is restricted to patients with more severely affected functional status [1]. PRP had a lower VAS score and higher IKDC subjective score at the 6th month after treatment and significantly less WOMAC score during the follow-up period. As compared to the HA, the VAS score, WOMAC score, and IKDC subjective score all revealed better PRP results. There were no significant differences in adverse event rates comparing PRP versus placebo or HA. There were no significant differences between triple PRP application and single PRP application in short-term curative effect
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