Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of Knee Osteoarthritis: A systematic review and meta-analysis

Hassan Niroomand Sadabad, Masoud Behzadifar, Farzad Arasteh, Meysam Behzadifar, Hamid Reza Dehghan, Hassan Niroomand Sadabad, Masoud Behzadifar, Farzad Arasteh, Meysam Behzadifar, Hamid Reza Dehghan

Abstract

Introduction: Knee osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints, knee osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and platelet-rich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis.

Methods: Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software.

Results: Seven studies with 722 subjects (364 participants in PRP and 358 participants in the HA group) were analyzed. The WOMAC PRP compared to HA, SMD = -0.75 (95% CI: -1.33 to -0.18, I2 = 92.6%) in treatment of knee osteoarthritis was statistically significant and PRP was more effective.

Conclusion: The results of this meta-analysis two years after PRP injection showed the efficacy of PRP versus HA. However, further studies are required to determine the longer-term effects.

Keywords: efficacy; hyaluronic acid; meta-analysis; platelet-rich plasma.

Figures

Figure 1
Figure 1
Flowchart of selection of included studies
Figure 2
Figure 2
Risk of bias graph of the included studies
Figure 3
Figure 3
Forest plot of Standardized Mean Differences (SMD) and 95% confidence intervals (CIs) of Western Ontario and McMaster University Arthritis Index (WOMAC), Platelet - Rich Plasma Compared to Hyaluronic Acid in the included studies
Figure 4
Figure 4
Sensitivity analysis of studies included
Figure 5
Figure 5
Cumulative analysis of studies included

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Source: PubMed

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