Purpose
The aim of our study is to compare the efficacy of platelet-rich plasma (PRP) and
viscosupplementation (hyaluronic acid [HA]) intra-articular injections for the treatment
of knee cartilage degenerative lesions and osteoarthritis (OA).
Methods
The study involved 150 patients affected by cartilage degenerative lesions and early
and severe OA. Fifty symptomatic patients were treated with 3 autologous PRP intra-articular
injections and were evaluated prospectively at enrollment and at 2- and 6-month follow-up.
The results obtained were compared with 2 homogeneous groups of patients treated with
HA injections. One group was treated with injections of high–molecular weight HA;
the other group was treated with low–molecular weight (LW) HA. International Knee
Documentation Committee and EQ VAS scores were used for clinical evaluation; adverse
events and patient satisfaction were also recorded.
Results
At 2 months' follow-up, the PRP and LW HA groups showed a similar improvement, with
higher results compared with the high–molecular weight HA group (P < .005). At 6 months' follow-up, better results were observed in the PRP group (P < .005). PRP and LW HA treatments offered similar results in patients aged over 50
years and in the treatment of advanced OA. PRP showed a better performance compared
with HA in younger patients affected by cartilage lesions or early OA.
Conclusions
Autologous PRP injections showed more and longer efficacy than HA injections in reducing
pain and symptoms and recovering articular function. Better results were achieved
in younger and more active patients with a low degree of cartilage degeneration, whereas
a worse outcome was obtained in more degenerated joints and in older patients, in
whom results similar to those of viscosupplementation have been observed.
Level of Evidence
Level II, prospective comparative study.
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Article info
Publication history
Published online: August 11, 2011
Accepted:
May 13,
2011
Received:
July 20,
2010
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
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- Platelet-Rich Plasma Versus Hyaluronic AcidArthroscopyVol. 28Issue 11
- PreviewIn recent studies, platelet-rich plasma has been considered as a new medical treatment for joint diseases, but there have been few evidence-based studies about it. We have read the article entitled “Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis” by Kon et al.1 with interest. It was a valuable study. However, there are some limitations that we would like to point out:
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