Intra-articular platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis.

PURPOSE

Platelet-rich plasma (PRP) and hyaluronic acid (HA) have been increasingly used in recent years to treat knee osteoarthritis (OA). However, whether PRP is superior to HA is controversial.

METHODS

We conducted an electronic search of PubMed, Embase, ScienceDirect, and Cochrane library. The pooled data were analyzed using RevMan 5.1.

RESULTS

Three prospective and ten randomized trials were identified. PRP injections reduced pain more effectively than HA injections in OA of the knee at 6 months (mean difference [MD]=-14.18; 95% confidence interval [CI]: -26.12 to -2.23; =0.02; =95%) and 12 months (MD=-15.25; 95% CI: -22.17 to -8.32; <0.01; =81%) of follow-up evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, while the VAS showed no significant difference at 3 months (MD=-0.98; 95% CI: -2.55 to 0.59; =0.22; =90%) and 6 months (MD=-0.82; 95% CI: -1.80 to 0.16; =0.1; =83%). Additionally, similar results were observed for the function recovery according to the WOMAC function score and EuroQol-visual analog scales.

CONCLUSION

The intra-articular injection of PRP was not obviously superior to HA in knee OA. Due to the limited quality and data of the evidence currently available, more high-quality randomized controlled trials are required.