Comparison Between the Effects of Intra Articular Platelet Rich Plasma and Combination of Platelet Rich Plasma and Hyaluronic Acid in the Treatment of Mild to Moderate Osteoarthritis of the Knee: A Two-year Prospective Study on Functional Outcome

Abstract

Background: Knee osteoarthritis (OA) remains a predominant degenerative joint disorder, compromising quality of life and imposing economic burdens. Amidst prevalent treatments, platelet-rich plasma (PRP) has emerged as a potential therapeutic option. This study aimed to evaluate the efficacy of PRP, alone and in combination with hyaluronic acid (HA), compared to other treatments for knee OA.

Methods: A prospective comparative study was conducted involving 100 patients with mild to moderate knee OA, categorized into two treatment groups: PRP alone and PRP combined with HA. The patients received either PRP alone or PRP with HA at weekly intervals for 3 consecutive weeks. Clinical outcomes in pain reduction and functional recovery were assessed based on Western Ontario and McMasters University Arthritis Index (WOMAC) and VAS (Visual Analogue Scale) scores measured at baseline and then at 2,6,12 and 24 months. 

Results:  Patients treated with PRP + HA consistently exhibited a lower mean VAS score when compared to the PRP group at each follow-up interval (2, 6, 12, and 24 months) as indicated by p-values of 0.001. The WOMAC scores were nearly identical in both the groups at 2-month mark. However, from the 6-month interval onwards, the PRP + Hyaluronic Acid group showed consistently better overall outcomes, with lower mean total WOMAC scores. These differences were statistically significant from 6 months to 24 months, with p-values ranging from 0.017 to 0.001.

Conclusion: PRP, especially when combined with HA, emerges as a promising therapeutic intervention for mild to moderate knee OA. The marked improvement in pain alleviation, functional recovery, with minimal or no adverse effects underscores its potential in clinical practice for treatment of OA knee.  However, further research is necessitated to streamline protocols and validate long-term outcomes.

Keywords: Knee Osteoarthritis, Platelet-Rich Plasma, Hyaluronic Acid, Intra articular therapies, Pain Reduction, Therapeutic Efficacy.