A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA)
Abstract Introduction KOA, a chronic degenerative joint disease, is commonly treated with intra-articular HA and PRP, used alone or in combination. However, the efficacy and safety of combination therapy (PRP + HA) remain unclear. Aim The aim of this systematic review and meta-analysis is to assess...
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2025-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-05429-w |
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| author | Dan Du Yuan Liang |
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| description | Abstract Introduction KOA, a chronic degenerative joint disease, is commonly treated with intra-articular HA and PRP, used alone or in combination. However, the efficacy and safety of combination therapy (PRP + HA) remain unclear. Aim The aim of this systematic review and meta-analysis is to assess the clinical effectiveness and safety profile of PRP + HA versus PRP monotherapy for KOA. Material and methods A systematic search was conducted using four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals. The mean difference (MD) and risk ratio (RR) was calculated, along with their 95% confidence intervals. We assessed heterogeneity using Cochrane Q and I2statistics and the appropriate p-value. The analysis used RevMan 5.4. GRADE system was used for evidence assessment for each outcome parameter. Results This meta-analysis of 11 RCTs (n = 1023 KOA patients) revealed that PRP + HA has substantial effectiveness than PRP alone in reducing OMAC total scores [MD -1.77 (95% CI -2.20 to − 1.34); I2 = 10%, and p < 0.001], VAS scores [MD -4.27 (95% CI -4.96 to − 3.58); I2 = 13%, and p < 0.001], and Lequesne index score [MD -5.48 (95% CI -6.56 to − 4.40); I2 = 16%, and p < 0.001], while increasing IKDC scores [MD -2.10 (95% CI -3.70 to − 0.50); I2 = 9%, and p = 0.01], with low risk of adverse events [RR 0.41 (95% CI 0.35 to 0.48); I2 = 12%, and p < 0.001]. Conclusion This meta-analysis reveals that, for patients with KOA, PRP + HA therapy is safe and yields better outcomes in pain relief and functional improvement compared to PRP monotherapy. |
| format | Article |
| id | doaj-art-83d918702b1f4574b939b0922ddd0a0d |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-83d918702b1f4574b939b0922ddd0a0d2025-01-19T12:32:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111410.1186/s13018-024-05429-wA meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA)Dan Du0Yuan Liang1General Practice, 920th Hospital of Joint Logistics Support Force, PLAGeneral Practice, 920th Hospital of Joint Logistics Support Force, PLAAbstract Introduction KOA, a chronic degenerative joint disease, is commonly treated with intra-articular HA and PRP, used alone or in combination. However, the efficacy and safety of combination therapy (PRP + HA) remain unclear. Aim The aim of this systematic review and meta-analysis is to assess the clinical effectiveness and safety profile of PRP + HA versus PRP monotherapy for KOA. Material and methods A systematic search was conducted using four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals. The mean difference (MD) and risk ratio (RR) was calculated, along with their 95% confidence intervals. We assessed heterogeneity using Cochrane Q and I2statistics and the appropriate p-value. The analysis used RevMan 5.4. GRADE system was used for evidence assessment for each outcome parameter. Results This meta-analysis of 11 RCTs (n = 1023 KOA patients) revealed that PRP + HA has substantial effectiveness than PRP alone in reducing OMAC total scores [MD -1.77 (95% CI -2.20 to − 1.34); I2 = 10%, and p < 0.001], VAS scores [MD -4.27 (95% CI -4.96 to − 3.58); I2 = 13%, and p < 0.001], and Lequesne index score [MD -5.48 (95% CI -6.56 to − 4.40); I2 = 16%, and p < 0.001], while increasing IKDC scores [MD -2.10 (95% CI -3.70 to − 0.50); I2 = 9%, and p = 0.01], with low risk of adverse events [RR 0.41 (95% CI 0.35 to 0.48); I2 = 12%, and p < 0.001]. Conclusion This meta-analysis reveals that, for patients with KOA, PRP + HA therapy is safe and yields better outcomes in pain relief and functional improvement compared to PRP monotherapy.https://doi.org/10.1186/s13018-024-05429-wKnee osteoarthritis (KOA)Platelet-rich plasma (PRP)Hyaluronic acid (HA)Western ontario and McMaster universities arthritis index (WOMAC) total scoresVisual analogue scale (VAS)scoresInternational knee documentation committee (IKDC) scores |
| spellingShingle | Dan Du Yuan Liang A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) Journal of Orthopaedic Surgery and Research Knee osteoarthritis (KOA) Platelet-rich plasma (PRP) Hyaluronic acid (HA) Western ontario and McMaster universities arthritis index (WOMAC) total scores Visual analogue scale (VAS)scores International knee documentation committee (IKDC) scores |
| title | A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) |
| title_full | A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) |
| title_fullStr | A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) |
| title_full_unstemmed | A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) |
| title_short | A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) |
| title_sort | meta analysis and systematic review of the clinical efficacy and safety of platelet rich plasma combined with hyaluronic acid prp ha versus prp monotherapy for knee osteoarthritis koa |
| topic | Knee osteoarthritis (KOA) Platelet-rich plasma (PRP) Hyaluronic acid (HA) Western ontario and McMaster universities arthritis index (WOMAC) total scores Visual analogue scale (VAS)scores International knee documentation committee (IKDC) scores |
| url | https://doi.org/10.1186/s13018-024-05429-w |
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