Efficacy of different platelet-rich plasma injections in the treatment of mild-moderate knee osteoarthritis: A systematic review and meta-analysis.

Abstract

This study aimed to compare the efficacy of different numbered sets of injections of platelet-rich plasma (PRP) in the treatment of mild-moderate knee osteoarthritis (OA). A comprehensive search in three databases of Cochrane Library, Embase, and PubMed was conducted to find relevant articles that investigated the efficacy of PRP injection therapies in the treatment of mild-moderate knee OA through August 2020. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores were the primary outcomes and visual analogue scale (VAS) was the secondary outcome. The pooled improvements amongst different injection therapies were compared. No significant differences in the improvement of WOMAC pain were observed amongst 1-, 2-, and 3-injection therapies at 3- (P=.26) and 6-month (P=.13) follow-ups. For a 12-month follow-up, the difference amongst different therapies reached borderline significance (P=.05) in which 3-injection therapy had a significantly better improvement than 2-injection therapy (P=.02) and reached borderline significance compared with 1-injection (P=.07). However, no significant differences in the improvement of VAS scores were observed amongst three injection therapies for all the follow-up visits (P>.05). For WOMAC function score, 3-injection therapy performed significantly better than 1-injection (P<.00001) or 2-injection therapy (P<.0001) only at 12-month follow-up visit. Our results demonstrated that 3-injection therapy of PRP in the treatment of mild-moderate knee OA had the best efficacy in pain relief and function improvement compared with 1- and 2-injection therapies.