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: Qinglin Liu, Haijiao Ye, Yang Yang, Hao Chen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0314878
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author Qinglin Liu
Haijiao Ye
Yang Yang
Hao Chen
author_facet Qinglin Liu
Haijiao Ye
Yang Yang
Hao Chen
author_sort Qinglin Liu
collection DOAJ
description <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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spelling doaj-art-4b4f07d29326490989b61a8e24a0be4f2025-08-20T03:22:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01203e031487810.1371/journal.pone.0314878The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.Qinglin LiuHaijiao YeYang YangHao Chen<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.https://doi.org/10.1371/journal.pone.0314878
spellingShingle Qinglin Liu
Haijiao Ye
Yang Yang
Hao Chen
The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
PLoS ONE
title The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
title_full The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
title_fullStr The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
title_full_unstemmed The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
title_short The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis.
title_sort efficacy and safety of intra articular platelet rich plasma versus sodium hyaluronate for the treatment of osteoarthritis meta analysis
url https://doi.org/10.1371/journal.pone.0314878
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