Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trialReport as inadecuate

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BMC Musculoskeletal Disorders

, 13:229

Orthopedics and biomechanics


BackgroundPlatelet Rich Plasma PRP, a blood-derived product rich in growth factors, is a promising treatment for cartilage defects but there is still a lack of clinical evidence. The aim of this study is to show, through a randomized double blind prospective trial, the efficacy of this procedure, by comparing PRP to Hyaluronic Acid HA injections for the treatment of knee chondropathy or osteoarthritis OA.

Methods109 patients 55 treated with HA and 54 with PRP were treated and evaluated at 12 months of follow-up. The patients were enrolled according to the following inclusion criteria: age> 18 years, history of chronic at least 4 months pain or swelling of the knee and imaging findings of degenerative changes of the joint Kellgren-Lawrence Score up to 3. A cycle of 3 weekly injections was administered blindly. All patients were prospectively evaluated before and at 2, 6, and 12 months after the treatment by: IKDC, EQ-VAS, TEGNER, and KOOS scores. Range of motion and knee circumference changes were measured over time. Adverse events and patient satisfaction were also recorded.

ResultsOnly minor adverse events were detected in some patients, such as mild pain and effusion after the injections, in particular in the PRP group, where a significantly higher post-injective pain reaction was observed p=0.039. At the follow-up evaluations, both groups presented a clinical improvement but the comparison between the two groups showed a not statistically significant difference in all scores evaluated. A trend favorable for the PRP group was only found in patients with low grade articular degeneration Kellgren-Lawrence score up to 2.

ConclusionsResults suggest that PRP injections offer a significant clinical improvement up to one year of follow-up. However, conversely to what was shown by the current literature, for middle-aged patients with moderate signs of OA, PRP results were not better than those obtained with HA injections, and thus it should not be considered as first line treatment. More promising results are shown for its use in low grade degeneration, but they still have to be confirmed.

KeywordsGrowth factors PRP HA Intra-articular injections, Randomized, Degenerative, Knee Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-229 contains supplementary material, which is available to authorized users.

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Author: Giuseppe Filardo - Elizaveta Kon - Alessandro Di Martino - Berardo Di Matteo - Maria Letizia Merli - Annarita Cenacchi - Pi


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