Intra‑Articular Platelet‑Rich Plasma Injections VS Hyaluronic Acid for Patients with Knee Osteoarthritis: A Systematic Review

Abstract

Introduction One of the most common conditions leading to impairment, particularly in the elderly, is osteoarthritis (OA). Most often caused by knee and/or hip OA, OA is the most prevalent articular disease in the developed world and a major contributor to chronic. OA is recognized as a major contributor to disability and impairment, and it has a significant socioeconomic cost due to medical and surgical procedures, as well as lost productivity. OA is a complex chronic illness that begins with joint cartilage disintegration and progresses to synovitis, subchondral sclerosis, and the development of peripheral osteophytes. A treatment option for osteoarthritis cartilage injuries is platelet-rich plasma (PRP) therapy, which is linked to a decrease in tissue inflammation. However, there is still a lack of clinical research on PRP administration's price, length of treatment, and possible application as a treatment for articular cartilage injuries. Objectives This study aimed to examine the clinical outcomes of patients with knee osteoarthritis, comparing the clinical results of The Western Ontario and McMaster Universities Arthritis Index (WOMAC) between PRP and HA intra-articular injection. Methods The medical term “PRP”, “HA”, and “Knee Osteoarthritis” were used in Pubmed and Google Scholar to discover studies of the efficacy of Intra‑articular PRP injection VS HA in decreasing WOMAC scores up to October 2023. Two independent reviewers excluded the non-RCTs and other clinical studies irrelevant to the study question. Seven remaining studies were reviewed and screened for inclusion based on relevance to the subject and outcomes. Results Based on seven studies in this review, two studies showed that intra-articular platelet-rich plasma has a superior outcome on decreasing the WOMAC score than intra-articular hyaluronic acid injection with significant. Five of seven studies demonstrated that PRP has better outcomes on WOMAC score, even if not significantly. Conclusions PRP intra-articular injection is a clinically meaningful improvement for patients with knee OA, with no significant difference between treatment groups