Intra-articular platelet rich plasma vs hyaluronic acid intreatment of osteoarthritis of knee.a comparative study.

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.