Exploring the Superior Efficacy of Hyaluronic Acid and Platelet-Rich Plasma Co-Administration Over Hyaluronic Acid Alone in Pain Reduction and Functional Status Improvement of Knee Osteoarthritis Patients

Abstract

Objective: This study aimed to determine whether concurrent injection of hyaluronic acid (HA) with platelet-rich plasma (PRP) would enhance therapeutic effectiveness compared to HA alone in the management of knee osteoarthritis (OA) over a 12-month follow-up. Methodology: A prospective, comparative study was conducted in department of orthopedic Nawaz Sharif Medical College / Aziz Bhatti Shahed Hospital Gujrat from Jan 2023 To Dec 2023 on 100 patients with knee OA (Kellgren-Lawrence grades I-III). The patients were divided into two groups: Group 1, consisting of 50 patients, received intra-articular HA injections, while Group 2, comprising the remaining 50 patients, received a combination of HA and PRP. Pain and functional outcomes were assessed using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at baseline, and at 2, 6, and 12-months post-injection. Results: Assessments at baseline, 2 months, 6 months, and 12 months post-injection revealed significant improvement in both groups compared to baseline. However, patients in Group 2 (HA+PRP) showed significantly greater improvement than those in Group 1 (HA alone), with WOMAC scores at 2-, 6-, and 12-months yielding p-values of 0.001*, 0.001*, and 0.000*, respectively. Conclusions: The study concluded that the combination of PRP and HA is more effective than HA alone in reducing pain and improving joint function in patients with knee OA. The findings suggest that PRP+HA offers superior benefits for managing knee osteoarthritis compared to HA alone.