A meta analysis does not confirm hypothesis for Platelet-Rich Plasma (PRP) versus Hyaluronic Acid (HA) in Knee Osteoarthritis
Knee Osteoarthritis is the leading cause of degenerative joint disease leading to joint dysfunction and pain. Both, intra-articular injections of PRP and HA have demonstrated effective long-term clinical management of pain symptoms and improving functionality. In 2015, as systematic review was published opposing the application of HA to treat knee osteoarthritis. Researchers Wu et al were led to hypothesize that PRP may prove to be a better modality than HA in the treatment of knee osteoarthritis, and thus performed a meta analysis to verify this hypothesis.
Ten full-text manuscripts were ultimately selected with regard to search strategy, inclusion criteria for data selection, data extraction methodology, and assessment of study quality. Risk of bias identified inconsistencies in randomization of study design, blinding, and outcome data which contributed to performance bias and attrition bias. Data selection focused on randomized controlled trials with consistent injection frequency, whereby the total number of injections demonstrated a 1:1 ratio, PRP:HA. Study outcomes assessed via objective scoring systems evaluated the use of the International Knee Documentation Committee (IKDC), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Numeric Rating System (NRS), the Knee Osteoarthritis Outcome Score (KOOS), and the Visual Analogue Scale (VAS) that were included in each RCT considered in this meta analysis.
In conclusion, researchers Wu et al. did not confirm their hypothesis because their meta analysis found that KOOS did not significantly differ between PRP and HA; although, PRP was shown to be more effective than HA as determined by IKDC, WOMAC, and VAS. Limitations acknowledged by researchers account for the fact that this meta analysis was only based on English articles, the frequency of injections varied between studies even though it was consistent within each study, and follow-up times varied between studies. Further studies are needed to investigate treatment outcomes between PRP and HA modalities in the treatment of knee osteoarthritis in the absence of these study limitations.
Read full-text article https://journals.sagepub.com/doi/pdf/10.1177/2309499019887660