Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis
One article on PainSci cites Han 2019: Does Platelet-Rich Plasma Injection Work?
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
PURPOSE: The purpose of this meta-analysis was to compare platelet-rich plasma (PRP) and hyaluronic acid (HA) in patients with knee osteoarthritis (KOA).
METHODS: Randomized controlled trials (RCTs) comparing the use of PRP and HA in KOA patients were retrieved from each database from the establishment date to April 2018. Outcome measurements were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), International Knee Documentation Committee, and Lequesne Index scores and adverse events. The pooled data were evaluated with Review Manager 5.3.5.
RESULTS: Fifteen RCTs (N = 1,314) were included in our meta-analysis. The present meta-analysis indicated that PRP injections reduced pain more effectively than HA injections in patients with KOA at six and 12 months of follow-up, as evaluated by the WOMAC pain score; the VAS pain score showed a significant difference at 12 months. Moreover, better functional improvement was observed in the PRP group, as demonstrated by the WOMAC function score at three, six, and 12 months. Additionally, PRP injections did not display different adverse event rates compared with HA injections.
CONCLUSION: In terms of long-term pain relief and functional improvement, PRP injections might be more effective than HA injections as a treatment for KOA. The optimal dosage, the timing interval and frequency of injections, and the ideal treatment for different stages of KOA remain areas of concern for future investigations.
- “Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review,” de Vos et al, British Journal of Sports Medicine, 2014.
- “Impact of autologous blood injections in treatment of mid-portion Achilles tendinopathy: double blind randomised controlled trial,” Bell et al, British Medical Journal, 2013.
- “Platelet-rich therapies for musculoskeletal soft tissue injuries,” Moraes et al, Cochrane Database of Systematic Reviews, 2014.
- “Autologous growth factor injections in chronic tendinopathy,” Sandrey, Journal of Athletic Training, 2014.
- “Popular Blood Therapy May Not Work,” Gina Kolata, New York Times.
- “The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment,” Chen et al, American Journal of Sports Medicine, 2018.
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