Comparative study between platelet-rich plasma intraarticular injection versus hyaluronic acid in knee osteoarthritis

Abstract

Abstract Background Osteoarthritis (OA) is a major public health problem that causes pain and disability in one-third of all affected patients. It primarily affects the elderly populations. This study aimed to evaluate the efficacy of intraarticular injections of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in knee OA. Patients and methods This was a prospective study that included 40 adult patients with knee OA grades II and III, where 20 patients were treated with PRP intraarticular injection two injections 1 month apart (group A), and 20 patients were treated with HA injections generally administered as a weekly injection for 3 weeks (group B). Data were collected from January 2017 till February 2018. In group A, the age of patients ranged from 45.0 to 67.0 years; five (25%) patients were males and 15 (75%) patients were females; unilateral side was affected in four (20%) patients, and bilateral side was affected in 16 (80%) patients; and grade II OA cases were 12 patients, and grade III OA cases were seven (40%) patients. In group B, the age of patients ranged from 49 to 75 years; five (25%) patients were males and 15 (75%) patients were females; unilateral side was affected in eight (40%) patients, and bilateral side was affected in 12 (60%) patients; and grade II OA cases were 11 (55%) patients, and grade III OA patients were nine (45%) patients. The procedure was done on an outpatient basis and under complete aseptic technique. PRP or HA was injected intraarticularly through an anterolateral or anteromedial portal. Follow-up with the patients was for at least 6 months, and the results of treatment were assessed by the knee injury and osteoarthritis outcome score (KOOS). Results At the end of the follow-up period, which was 6 months, the KOOS in group A had improved to a mean score of 64.89 ± 17.97 points, as compared with the pre-injection score, which was 49.95 ± 14.21 points. In group B, at end of follow-up, the period score was 58.60 ± 19.10 points and the pre-injection score was 49.39 ± 19.97 points. Conclusion Both PRP and HA injections show significant improvement in grades II and III OA. The KOOS symptom subscale showed that PRP injections were more effective than HA injections in patients with grade II arthritis.