Intra-articular platelet-rich plasma vs. corticosteroid injections efficacy in knee osteoarthritis treatment: a systematic review

Abstract

Background: Osteoarthritis (OA) affects the entire joint structure. The most injured joints are the hands, knees, and hips. OA is a common disease all over the world, and a cause of disability in the elderly; hence, medicine is facing a steady challenge to find effective therapeutics to relieve the pain, improving symptoms for a better quality of life for patients. Purpose: To compare the results, in the recent literature, of intra-articular injection of platelet-rich plasma (PRP) and corticosteroids (CSs) in osteoarthritic knees at early and mid-term postinjection. Methods: A PubMed and CENTRAL (Cochrane Central Register of Controlled Trials) database search was performed. Initial screening yielded 108 randomized controlled trials, 17 results, and 17 others were added after updates. The final review includes nine randomized control trials, with outcome evaluating of knee OA by Western Ontario and McMaster Universities Arthritis Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Scale Index, and Visual Analog Scale. Results: PRP and CS intra-articular injections both are safe and effective treatments in knee OA for alleviating pain, and improving symptoms. It seems that PRP injections have prolonged and shown better improvement in some studies. However, the results do not prefer one method over the other. Conclusion: Up till now, it is not easy to draw firm conclusions about prioritizing PRP or CS injections for knee OA treatment due to the limitation of this review.

The Efficacy of Intra-articular Platelet-Rich Plasma Injection Versus Corticosteroid Injection in the Treatment of Knee Osteoarthritis: A Prospective Comparative Analysis

“…A study that was performed in Ireland suggested a similar role of PRP and CSs in the treatment of KOA [4]. A systemic review also suggested that PRP effects on KOA management last longer than CSs [9].…”

“…Greater scores indicate more pain, more joint stiffness, and more limitation in joint function; lower values indicate less pain, stiffness in the joints, and limitation in joint function. International studies have also employed WOMAC and VAS [ 9 , 10 ]. In the second section of the proforma, information about the grade of KOA and the side of the affected knee was also recorded.…”

“…The first section was about the age and gender whereas, in the second section, clinical evaluation of the patients was noted at baseline, first-month, second-month, and third-month follow-up visits. [9,10]. In the second section of the proforma, information about the grade of KOA and the side of the affected knee was also recorded.…”

“…On the other hand, corticosteroids (CSs) have comprehensive immunosuppressive and anti-inflammatory action. Intraarticular injections of CSs restrict T and B-cell activities and other inflammatory mechanisms, which reduce inflammatory changes in the joints and improve KOA symptoms [9][10][11].…”

The emerging role of lncRNAs in osteoarthritis development and potential therapy

“…Pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation in osteoarthritis ( Ouyang et al, 2023 ). For example, acetaminophen, ibuprofen, naproxen, corticosteroid injection, and hyaluronic acid injection, have been used to reduce pain and inflammation in osteoarthritis ( Shentu et al, 2022 ; Goyal et al, 2023 ; Idres and Samaan, 2023 ; Richard et al, 2023 ). Exercise, weight management, and physical therapy are useful for osteoarthritis patients ( Spanoudaki et al, 2023 ).…”