Abstract
BackgroundIn this study, we evaluated whether platelet-rich plasma (PRP) is superior to hyaluronic acid (HA) in the treatment of knee osteoarthritis.MethodsThe Cochrane Central Register of Controlled Trials, PubMed, and Embase databases were searched for English-language, human in vivo studies on the treatment of symptomatic knee osteoarthritis with intra-articular PRP compared with HA. The following keywords were used for the search: “platelet-rich plasma,” “PRP,” “platelet-rich fibrin,” “PRF,” “platelet,” “plasma,” “arthritis,” “osteoarthritis,” “gonarthrosis,” and “degeneration.”ResultsSeven articles reporting 908 patients and 908 knees were analyzed, including 44% men and 56% women with a mean age of 59.8 years. All studies met the minimal clinically important difference criteria and showed statistically significant improvements in clinical outcomes, including pain, physical function, and stiffness, with PRP treatment. All except two studies showed significant differences between PRP and HA regarding clinical outcomes of pain and function.ConclusionsPRP intra-articular injection of the knee may be an effective alternative treatment for knee OA, especially in patients with mild knee OA. Although some studies suggested that the effect of PRP was no better than HA, we found that it was no worse. A large, multicenter, randomized trial is needed to further assess the efficacy of PRP treatment for patients with knee OA.Trial registrationPROSPERO, CRD42016048394. Registered on October 2, 2016).
Highlights
In this study, we evaluated whether platelet-rich plasma (PRP) is superior to hyaluronic acid (HA) in the treatment of knee osteoarthritis
The following keywords were used for the search: “platelet-rich plasma,” “PRP,” “platelet-rich fibrin,” “PRF,” “platelet,” “plasma,” “arthritis,” “osteoarthritis,” “gonarthrosis,” and “degeneration.” In addition, presentations and abstracts from annual meetings of the American Academy of Orthopaedic Surgeons, the European League against
Search results Of the 242 nonduplicate citations identified from the literature, 17 clinical trials were screened for eligibility (Fig. 1)
Summary
We evaluated whether platelet-rich plasma (PRP) is superior to hyaluronic acid (HA) in the treatment of knee osteoarthritis. Osteoarthritis (OA) is a multifactorial chronic bone and joint disease characterized by articular cartilage degeneration that adversely impacts patient mobility and quality of life [1]. The goal of treatment for knee OA is to relieve pain, improve function and quality of life, and reduce disability. (HA) [4], corticosteroids, and platelet-rich plasma (PRP); oral nonsteroidal anti-inflammatory drugs; and physical therapy are important nonsurgical treatment options for knee OA. Differences between some of the key characteristics, including platelet concentration, anticoagulant and coagulation activation agent type, presence of inflammatory white blood cells, and activation level, can significantly affect the biological effect
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