Back to Search
Start Over
Platelet-Rich Plasma Versus Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis: Results at 5 Years of a Double-Blind, Randomized Controlled Trial.
- Source :
- American Journal of Sports Medicine; Feb2019, Vol. 47 Issue 2, p347-354, 8p
- Publication Year :
- 2019
-
Abstract
- Background: Platelet-rich plasma (PRP) injections have been proposed as a new conservative option for knee degeneration to provide symptomatic relief and delay surgical intervention. Although the current literature provides some evidence on the benefits of this technique compared with viscosupplementation, no studies have been performed to compare their long-term effects. Purpose: To compare the long-term clinical outcomes provided by intra-articular injections of either PRP or hyaluronic acid (HA) to treat knee degenerative disease. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with a history of chronic symptomatic knee degenerative changes and osteoarthritis (Kellgren-Lawrence grade 0-3) were enrolled: 192 patients were randomized to undergo 3 blinded weekly intra-articular injections of either PRP or HA. Patients were prospectively evaluated before the injection and then at 2, 6, 12, and 24 months and a mean of 64.3 months (SD, 7.8 months) of follow-up. Evaluation was based on International Knee Documentation Committee (IKDC) subjective (main outcome), EuroQol visual analog scale, and Tegner scores; 167 patients reached the final evaluation. Results: Both treatments were effective in improving knee functional status and symptoms over time: Mean ± SD IKDC subjective score improved significantly for both PRP and HA groups (P < .0005) and remained stable over time up to 24 months (from 53.3 ± 14.3 to 67.3 ± 18.1 and from 50.3 ± 13.2 to 62.1 ± 20.8 for PRP and HA groups, respectively). At final evaluation, a significant IKDC reduction was observed in both treatment groups, with the PRP group still presenting significantly higher values compared with baseline: PRP 60.5 ± 19.0 (P < .001 vs baseline), HA 55.7 ± 18.8 (not significant vs baseline). A comparative analysis showed no significant intergroup difference in any of the clinical scores at any follow-up point. The median duration of patient subjective perception of symptomatic relief was 9 months for HA and 12 months for PRP (not significant). The only significant difference was observed in the rate of reintervention at 24 months, which was significantly lower in the PRP group (22.6% vs 37.1%, P = .036). Conclusion: Both treatments were effective in improving knee functional status and symptoms over time. PRP did not provide an overall superior clinical improvement compared with HA in terms of either symptomatic-functional improvement at different follow-up points or effect duration. Registration: NCT01670578 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]
- Subjects :
- KNEE diseases
OSTEOARTHRITIS diagnosis
OSTEOARTHRITIS treatment
THERAPEUTIC use of hyaluronic acid
ANALYSIS of variance
CHI-squared test
COMPARATIVE studies
STATISTICAL correlation
INTRA-articular injections
MAGNETIC resonance imaging
MULTIVARIATE analysis
STATISTICS
SURVIVAL analysis (Biometry)
TIME
SAMPLE size (Statistics)
DATA analysis
STATISTICAL significance
RANDOMIZED controlled trials
VISUAL analog scale
TREATMENT effectiveness
REPEATED measures design
BLIND experiment
PATIENT selection
DATA analysis software
STATISTICAL models
DESCRIPTIVE statistics
KAPLAN-Meier estimator
PLATELET-rich plasma
LOG-rank test
MANN Whitney U Test
FRIEDMAN test (Statistics)
DIAGNOSIS
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 03635465
- Volume :
- 47
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- American Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 134897910
- Full Text :
- https://doi.org/10.1177/0363546518814532