Randomized, double-blind, controlled trial, phase III, to evaluate the use of platelet-rich plasma versus hyaluronic acid in hip coxarthrosis

Villanova-López, M.M.; Núñez-Núñez, María; Fernández-Prieto, D.; González-López, C.; García-Donaire, José Antonio; Pérez-Pérez, Antonio; Castillo, S.; Murillo-Izquierdo, M; Camean-Fernández, M.; Gutiérrez‐Pizarraya, Antonio; Navas-Iglesias, N; Roca-Ruiz, L.J.; Calleja‐Hernández, Miguel Ángel; Ballester-Alfaro, J.J.

doi:10.1016/j.recote.2020.02.003

Cited by 11 publications

(49 citation statements)

References 17 publications

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“…The effects of PRP versus HA for the treatment of symptomatic hip osteoarthritis was analysed in 6 randomised controlled trials [ 1 , 26 , 28 , 31 – 33 ], with different dosages of intra articular PRP, ranging from 1-2 ml to 6 ml.…”

Section: Discussionmentioning

confidence: 99%

“…PRP was found better then HA both for pain decrease and for functional improvement at short and long term [ 26 , 32 , 33 ]. Two authors showed, conversely, that HA had better results than PRP in pain relief until 16 weeks [ 33 ] and better functional scores at 12 months after injection [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…CS+HA improve ROM up to one year. Villanova et al 2020 [ 28 ] HA (37) PRP (37) 74 I-IV Synvisc-One® 60 mg/6 mL (6000 kDa) VS PRP 6 ml 1 VAS HHS WOMAC OARSI criteria T0: baseline T1: 1 week T2: 1 month T3:12 months Both groups showed improvements in VAS score at each follow-up. HA group showed a significative HHS score at T3 Brander et al 2019 [ 29 ] HA (182) SS (175) 357 III Hylan G-F 20® (6000 kDa) 48 mg/6 ml VS Saline solution 6ml 1 WOMAC PTGA T0: baseline T1: 4 weeks T2: 8 weeks T3: 16 weeks T4: 26weeks Significative improvements in both groups for all outcomes measures up to T4.…”

Section: Methodsmentioning

confidence: 99%

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State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review

Ferrara

Codazza

Coraci

et al. 2021

BMC Musculoskelet Disord

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Background Intra-articular hip injections for osteoarthritis represent a useful instrument to reduce pain and disability in the common clinical practice. Several medications can be injected locally with different level of evidence-based efficacy. Objective The objective of this systematic review is to investigate the effectiveness of intra-articular injections of different medications or substances for the pain treatment and the management of disability in subjects affected by hip osteoarthritis. Methods Two reviewers selected independently randomised controlled trials published in the last 10 years, using PubMed and Scopus databases. The risk of bias was evaluated with Cochrane library assessment tool. Results 12 randomised controlled trials have been selected. We found 8 papers comparing hyaluronic acid with platelet rich plasma, with corticosteroids and with saline solution; 1 paper compares two types of hyaluronic acid with different molecular weights; 3 papers study the effects of corticosteroids alone or compared to ketorolac or saline solution. Conclusions The studies reviewed were heterogeneous regarding sample size, level of osteoarthritis, evaluated with Kellegren-Lawrence score, medications used and follow up timings. However, we have observed that intra-articular injections of platelet-rich plasma seem to decrease pain at short term and disability at long term, in patients affected by hip osteoarthritis better than hyaluronic acid. The association of hyaluronic acid and corticosteroids could give better results compared to hyaluronic acid alone, while the use of intra-articular ketorolac and saline solution requires more studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review

Ferrara

Codazza

Coraci

et al. 2021

BMC Musculoskelet Disord

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“…Compared to other RCTs which were mostly used in meta-analyses [ 22 – 24 , 35 , 36 ], the results suggesting pain reduction and outcome improvement mostly concern the earlier months post-injection, gradually after which the PRP and PRP + HA groups maintain their effects as time goes on. In studies where PRP showed no superiority of over HA, the main reason seems to have been the higher age of the participants and entering patients with higher grades of OA into the study.…”

Section: Discussionmentioning

confidence: 86%

Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial

Nouri

Babaee

Peydayesh

et al. 2022

BMC Musculoskelet Disord

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Background Intra articular (IA) injection of platelet-rich plasma (PRP) and hyaluronic acid (HA) are of the new methods in the management of hip osteoarthritis (OA). The aim of this study was to compare the effectiveness of IA injections of PRP, HA and their combination in patients with hip OA. HA and PRP are two IA interventions that can be used in OA in the preoperative stages. Due to the different mechanisms of action, these two are proposed to have a synergistic effect by combining. Methods This is a randomized clinical trial with three parallel groups. In this study, patients with grade 2 and 3 hip OA were included, and were randomly divided into three injection groups: PRP, HA and PRP + HA. In either group, two injections with 2 weeks’ interval were performed into the hip joint under ultrasound guidance. Patients were assessed before the intervention, 2 months and 6 months after the second injection, using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne questionnaires. Results One hundred five patients were enrolled randomly in HA, PRP and PRP + HA groups. All three groups showed significant improvement in WOMAC, VAS, and Lequesne at 2 months and 6 months compared with baseline. Comparison of the 3 groups demonstrated significant differences regarding WOMAC and Lequesne total scores and the activities of daily living (ADL) subscale of Lequesne (P = 0.041, 0.001 and 0.002, respectively), in which the observed improvement at 6th month was significantly higher in the PRP + HA and PRP groups compared to the HA group. Conclusion Although all 3 interventions were associated with improvement of pain and function in patients with hip OA, the therapeutic effects of PRP and PRP + HA injections lasted longer (6 months), and the effects of these two interventions on patients’ performance, disability, and ADL were superior to HA in the long run. Moreover, the addition of HA to PRP was not associated with a significant increase in the therapeutic results. Trial registration The study was registered at Iranian Registry of Clinical Trials (IRCT) website http://www.irct.ir/, a WHO Primary Register setup, with the registration number of IRCT20130523013442N30 on 29/11/2019.

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“…A total of 30 articles 26 , 30 – 35 , 42 – 64 with an evidence level I were included out of the 144 records retrieved ( Figure 1 ). This meta-analysis included 2733 patients ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

Chen

Jin

Yao

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are non-surgical treatments for osteoarthritis (OA), but the comparison of their efficiency is still inconclusive. Objectives: The objectives of this study were to compare the efficacy of PRP and HA in the treatment of OA by meta-analysis and to explore the effects of different injection times and leukocyte concentration on the efficacy of PRP. Design: Meta-analysis and subgroup analysis were conducted. The data were analyzed by Review Manager v5.4.1. Data sources and methods: Articles were retrieved and screened from PubMed, the Cochrane Library, Web of Science, and Embase. The outcome included the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS), adverse events (AEs), the International Knee Documentation Committee (IKDC), and the satisfaction rate. Results: A total of 30 articles involving 2733 patients were included. The total WOMAC score and IKDC score of the PRP group were better than those of the HA group at the last follow-up time, while there was no significant difference in AEs, satisfaction rate, and VAS between the two groups. In our subgroup analysis, there was no significant difference between single-injection PRP and triple-injection PRP. Leukocyte-poor PRP (LP-PRP) was better than leukocyte-rich PRP (LR-PRP) in IKDC, but there was no significant difference between them in the other scores. Conclusions: In the treatment of OA, compared with HA, PRP performed better in the improvement of the patient’s function. There was no significant difference in VAS and AEs between the two groups, and the safety was comparable. LP-PRP looked to be superior to LR-PRP in functional recovery, but there appeared to be no significant difference in pain relief between them. There was no significant difference between single PRP and triple PRP in the subgroup analysis.

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Randomized, double-blind, controlled trial, phase III, to evaluate the use of platelet-rich plasma versus hyaluronic acid in hip coxarthrosis

Cited by 11 publications

References 17 publications

State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review

State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review

Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial

Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials

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