The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
<h4>Background</h4>Knee osteoarthritis (KOA) is a common degenerative joint disease that primarily affects the elderly individuals. Traditional treatments include medications and physical therapy, but recent attention has turned to platelet-rich plasma (PRP) and hyaluronic acid (HA) inje...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0314878 |
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| Summary: | <h4>Background</h4>Knee osteoarthritis (KOA) is a common degenerative joint disease that primarily affects the elderly individuals. Traditional treatments include medications and physical therapy, but recent attention has turned to platelet-rich plasma (PRP) and hyaluronic acid (HA) injection therapies.<h4>Objective</h4>This meta-analysis aimed to evaluate the efficacy and safety of PRP combined with HA versus PRP alone in the treatment of KOA.<h4>Methods</h4>We conducted a comprehensive literature search of the PubMed, Embase, and Cochrane Library databases, which included covering publications from their inception to July 2024. Studies comparing PRP+HA with PRP alone were selected. Data on visual analog scale (VAS) scores, WOMAC total scores, Lequesne scores, and adverse events were extracted. Statistical analysis was performed via Review Manager 5.3.5.<h4>Result</h4>This meta-analysis included 16 studies involving a total of 1,384 patients. The VAS score comparison indicated that, in the long term, PRP combined with HA was more effective in reducing knee pain than PRP alone was (SMD: -0.30, 95% CI: -0.53 to -0.06, P = 0.01). The combined PRP and HA treatment achieved better results in terms of the WOMAC total score (MD = -6.58, 95% CI: -10.65 to -2.52, P < 0.001). At the 6-month follow-up, the Lequesne index score comparison revealed that PRP combined with HA significantly improved knee pain scores compared with PRP alone (MD = -1.38, 95% CI: -1.91 to -0.86, P < 0.001). In terms of adverse events, PRP+HA was associated with a lower risk of adverse events than PRP alone was (OR = 0.54, 95% CI: 0.33 to 0.85, P = 0.009).<h4>Conclusion</h4>PRP combined with HA offers significant long-term benefits in pain relief and functional improvement over PRP alone for knee osteoarthritis, with better safety. The sequence of injection may influence treatment outcomes.<h4>Systematic review registration</h4>PROSPERO CRD42024598691. |
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| ISSN: | 1932-6203 |