Abstract:
Introduction: Osteoarthritis (OA) of the knee is a prevalent degenerative joint disease characterized
by progressive cartilage deterioration, pain, and functional limitation. Intra-articular injections of
biologic agents have emerged as potential disease-modifying interventions for knee OA. This study
aimed to compare the efficacy and safety of intra-articular platelet-rich plasma (PRP) versus
hyaluronic acid (HA) in the treatment of mild to moderate knee OA.
Methods: In this prospective comparative study, 70 patients with Kellgren-Lawrence grade 1-2 knee
OA were randomly allocated to receive either PRP (n=35) or HA (n=35) intra-articular injections.
Patients were evaluated at baseline, 3 months, and 6 months post-injection using the Visual Analog
Scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index
(WOMAC) for functional assessment. Complications and adverse events were recorded throughout
the follow-up period.
Results: Demographic characteristics were comparable between groups. At 3 months, the HA group
showed significantly better pain reduction (VAS: 3.12±0.48 vs 4.65±0.68; p<0.001) and functional
improvement (WOMAC: 31.7±4.3 vs 47.2±5.4; p<0.001) compared to the PRP group. However, at 6
months, the pattern reversed, with the PRP group demonstrating superior pain relief (VAS: 2.08±0.45
vs 3.14±0.51; p<0.001) and functional outcomes (WOMAC: 22.11±3.2 vs 32.4±4.6; p<0.001). The
PRP group exhibited a better safety profile with no cases of infection or synovitis, compared to the
HA group which reported infection (5.7%) and synovitis (11.4%).
Conclusion: Intra-articular PRP and HA demonstrate a distinct temporal efficacy pattern in knee OA
management, with HA providing superior short-term benefits at 3 months and PRP showing
significantly better long-term outcomes at 6 months. PRP also exhibited a more favorable safety
profile. These findings suggest that PRP may be the preferred option for long-term management of
mild to moderate knee OA, particularly in patients seeking sustained symptom relief and functional
improvement.
