Open AccessComparing the efficacy of dual Platelet‐Rich Plasma (PRP) and Hyaluronic Acid (HA) therapy with PRP‐alone therapy in the treatment of knee osteoarthritis: a systematic review and meta‐analysis
Author(s) -
Aw Angeline Ai Ling,
Leeu Jun Jie,
Tao Xinyu,
Bin Abd Razak Hamid Rahmatullah
Publication year - 2021
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-021-00415-1
Subject(s) - medicine , womac , adverse effect , cochrane library , osteoarthritis , meta analysis , platelet rich plasma , randomized controlled trial , physical therapy , surgery , alternative medicine , pathology , platelet
Purpose This study aims to compare the efficacy of a dual therapy of Platelet‐Rich Plasma (PRP) and Hyaluronic Acid (HA) compared with PRP‐alone therapy in the treatment of knee osteoarthritis (KOA). Methods PubMed, Embase, CINAHL, SCOPUS, Cochrane Library, grey literature and bibliographic references were searched from inception to January 2021. Only randomized controlled trials (RCTs) and retrospective cohort studies comparing the effect of PRP and HA versus PRP‐alone therapy for KOA were included. Literature retrieval and data extraction were conducted by three independent reviewers. Pooled analysis of Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), International Knee Documentation Committee (IKDC) scores and adverse events were conducted. Results Ten studies (7 RCTs, 3 cohort studies) involving 983 patients were covered. Dual PRP and HA therapy resulted in significant reduction in VAS compared to PRP‐alone therapy at 4–6 weeks ( P < 0.00001) and 12 months ( P < 0.00001). Dual therapy resulted in better WOMAC score improvement at 3 ( P = 0.02), 6 ( P = 0.05) and 12 months ( P < 0.0001) compared to PRP‐alone therapy. The IKDC score for dual therapy was also higher at 6 months compared to PRP‐alone therapy ( P = 0.007). Regarding adverse events, dual therapy was generally safer than PRP‐alone therapy ( P = 0.02). Conclusion While there is a paucity of large high‐quality Level I studies, current best evidence suggests that dual therapy with PRP and HA for KOA may be effective at providing pain relief and improvement in function up to 1 year following administration. Level of evidence II.