INTRA-ARTICULAR INJECTIONS OF PLATELET-RICH PLASMA COMBINED WITH HYALURONIC ACID VERSUS HYALURONIC ACID ALONE IN TREATMENT OF KNEE OSTEOARTHRITIS.

Seleem N.A.*, Elshereef E., Elhosary A.A., Salama N.M.

ABSTRACT

Osteoarthritis (OA) is a complex disease caused mainly by inflammatory mediators. The last non-operative treatment modality, when other conservative treatments are ineffective is intra-articular (IA) injections with corticosteroids, viscosupplements or blood-derived products. Purpose: The aim of this study was to compare the efficacy of Cellular Matrix-PRP-HA (CM-PRP-HA), a combination of autologous platelet-rich plasma (PRP) and hyaluronic acid (HA) prepared using a dedicated medical device, to HA alone in IA injections for treatment of osteoarthritic knee. Methods: The study involved 100 symptomatic patients with knee cartilage degenerative lesions (Kellgren Lawrence scale grade 0 to III). Fifty patients were treated with IA injections of autologous CM-PRP-HA combination that was repeated 3 times with 3 weeks interval, while the other 50 patients were treated with IA HA injections. All patients were clinically evaluated pretreatment (basal) and at 2,6 and 12-month follow up visits by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: At each follow up visit, both groups showed a highly significant improvement when compared with the basal assessment and the same results were obtained upon comparing 12- month follow up visit with the 2- month one. The infra-group comparison showed, at each follow up evaluation, a significantly higher improvement for the group treated with CM-PRP-HA in respect to HA alone. Conclusion: IA injections of CM-PRP-HA showed more efficacy than HA injections in reducing pain and symptoms of mild to moderate knee degenerative osteoarthritis.

Keywords: knee osteoarthritis, autologous PRP and hyaluronic acid.