The Role of Hyaluronic Acid Versus Platelet-Rich Plasma in Treating Osteoarthritis

A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intraarticular Biology for the Treatment of Knee Osteoarthritis

By: Brian J. Cole, MD, MBA, Vasili Karas, MD, MS, Kristen Hussey, MS, Kyle Pilz, MMS, PA-C, and Lisa A. Fortier, DVM, PhD, DACVS Investigation performed at the Rush University Medical Center, Chicago, Illinois

Purpose: To compare the clinical and biological effects of an intra-articular injection of PRP with those of an intra-articular injection of HA in patients with mild to moderate knee OA. Interview originally published in the American Journal of Sports Medicine as a February Podcast.

bcmdThe use of plateletrich plasma (PRP) for the treatment of osteoarthritis (OA) has demonstrated mixed clinical outcomes in randomized controlled trials when compared with hyaluronic acid(HA), an accepted nonsurgical treatment for symptomatic OA. Biological analysis of PRP has demonstrated an anti-inflammatory effect on the intra-articular environment.

We found no difference between HA and PRP at any time point in the primary outcome measure: the patient-reported WOMAC pain score. Significant improvements were seen in other patient-reported outcome measures, with results favoring PRP over HA. Preceding a significant difference in subjective outcomes favoring PRP, there was a trend toward a decrease in 2 proinflammatory cytokines, which suggest that the anti-inflammatory properties of PRP may contribute to an improvement of symptoms.

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