Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis.

Abstract

viscosupplementation (hyaluronic acid [HA]) in hip osteoarthritis. Material and methods: A total of 43 patients affected by monolateral severe hip osteoarthritis (OA) were included in the study. Patients were randomized to receive either intra-articular PRP (3 ml) or HA (30 mg/2 ml; 1,000-2,900 kDa), 3 injections in total – 1/week. Clinical assessments for each patient were made at baseline (T0), 4 (T1), and 16 weeks (T2) of follow-up. The primary efficacy outcome was pain reduction as measured by VAS and by WOMAC pain subscale. Results: Data analysis revealed that, compared to T0, in the PRP-treated group VAS scores significantly decreased at T1 but not at T2, thereby indicating an early effect on pain which was not maintained at a longer term follow-up. In the HA group a significant decrease of both VAS and WOMAC values was registered only between T0 and T2. Conclusions: Intra-articular PRP had an immediate effect on pain that was not maintained at longer term follow-up when, on the contrary, the effects of intra-articular HA were evident.

Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses

“…However, we were not able to confirm the effect of other aspects of PRP on the treatment of KOA patients, including numbers of PRP injections (1 or ≥ 2), injection intervals (weekly or monthly), PRP spinning techniques (single or double), mean platelet concentration (> or < 5 × baseline), PRP category (LP-PRP or LR-PRP), and use an activator or not. In the past few years, more and more researchers noticed the potential of PRP in the treatment of musculoskeletal diseases, such as rotator cuff tear, lateral epicondylitis, patellar tendinopathy, osteoarthritis, and Achilles tendon repair [19][20][21][22][23][24][25][26]. Given the properties of regenerative effect and anti-inflammatory potential in PRP, a number of researches [19,23,24,[27][28][29][30][31][32][33][34][35] explored the curative effect of intraarticular PRP injection in the treatment of patients with osteoarthritis, especially with knee osteoarthritis.…”

“…Various growth factors and cytokines are released after the degranulation of platelets and to accelerate cartilage matrix synthesis, restrain synovial membrane inflammation, and promote cartilage healing [17,18]. Owing to the properties of regenerative effect and anti-inflammatory potential, PRP is widely used in musculoskeletal diseases, such as rotator cuff tear, lateral epicondylitis, patellar tendinopathy, osteoarthritis [19][20][21][22][23][24][25][26].…”

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

“…Battaglia et al [55] found improved function and decreased pain but LP‐PRP was not found superior to HA at 1‐year follow‐up. Di Sante et al [56] reported superior short‐term pain relief with hip intra‐articular PRP injection; however, long‐term pain relief was superior with HA injection. A 2018 meta‐analysis of randomized controlled trials of PRP vs HA in hip OA [57] concluded that PRP‐treated patients demonstrated significant decrease of pain at 2 months with equivalent improvement of function and no significant difference noted at 6 and 12 months.…”

“…Published data are mixed with fewer robust studies for Achilles and patella tendinopathy, limiting our ability to draw conclusions about efficacy. Table 2 presents a list of studies [49‐89] and levels of evidence.…”

Osteoarthritis: Current Clinical Concept and Some Promising Therapeutic Approaches

“…Так, в работе L. Di Sante и соавт. [75] оценивалась эффективность ОТП при лечении ОА тазобедренного сус-тава. 43 пациента получили по три еженедельных внутри-суставных инъекции ОТП или ГРК.…”