Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

Abstract

Introduction/objectives Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane® (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA. Method Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up. Results Mean age was 55.8 ± 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p < 0.05). There were no statistically significant differences between the groups in terms of first week pain relief (p > 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group’s rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group. Conclusion As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group. Key Points• The short-term effects of intra-articular HA, peptide, and PRP injections were compared in knee osteoarthritis.• HA, peptide, and PRP injections may be useful in pain relief and functional improvement in knee osteoarthritis.

The Role of Cashew (Anacardium occidentale L.) Nuts on an Experimental Model of Painful Degenerative Joint Disease

“…Platelet-rich plasma is beginning to replace the more common injectable therapies of intra-articular corticosteroids and hyaluronic acid. New evidences suggest pain relief and functional improvement were obtained after the intra-articular hyaluronic acid, peptide and platelet-rich plasma injections in osteoarthritis, and decrease in pain was better in the peptide group [34]. Small studies have examined prolotherapy and stem cell therapy, and demonstrate some benefits.…”

Comparative efficacy and safety of injection therapies for knee osteoarthritis

“…Finally, many high-quality RCTs were excluded because of the stringent inclusion criteria, and the feasibility of the articles depends on the methodological quality of the included articles. [ 14 , 15 ]…”

The use of platelet-rich plasma in studies with early knee osteoarthritis versus advanced stages of the disease: a systematic review and meta-analysis of 31 randomized clinical trials

“…In total, this systematic review included data from 2705 subjects (1298 in the PRP arm and 1407 in the control arm). The included studies were published between 2012 [21] and 2020 [22][23][24][25][26]. Participants enrolled in the selected studies included individuals diagnosed exclusively with knee OA.…”

“…Participants enrolled in the selected studies included individuals diagnosed exclusively with knee OA. The participants' follow-up varied among the studies from 3 months [25,27] to 2 years [28]. The trials reported the use of different PRP formulations; six studies did not report sufficient information about the PRP used [27,[29][30][31][32][33], and they could not be classified.…”

“…The most frequent control group used in the studies was hyaluronic acid, followed by corticosteroid, prolotherapy, ozone, peptide, bone marrow aspirate, and saline solution. The included studies were divided into three categories according to their Kellgren-Lawrence OA classification: stage 1-2 with a total of 5 studies [9,29,30,36,37], stage 1-3 with a total of 20 studies [21, 22, 39-48, 23, 24, 27, 28, 31-33, 38], and stage 1-4 with a total of 6 studies [11,25,26,[49][50][51]. Complete information regarding the study characteristics and patients is shown in Table 1.…”