Intra-articular platelet-rich plasma versus hyaluronic acid injections in patients with advanced knee osteoarthritis

Background Osteoarthritis (OA) is a chronic disease that can be treated by several modality, one of which intra-articular injection. Hyaluronic acid (HA) and platelet-rich plasma (PRP) were approved in the management of OA grade 2 and grade 3 with good response. The aim of this study was to compare the effect of intra-articular injection of PRP versus HA in patients with knee OA grade 4. Patients and methods The study was carried out on 67 patients having knee OA grade 4, who were divided into two groups: group 1 included 33 patients who were treated with intra-articular injection of leukocyte-low PRP, and group 2 included 34 patients who were treated with intra-articular injection of high-molecular-weight hyaluronic acid. Both groups were evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and MRI before and 6 months after injection. Results In group 1, there were no statistically significant improvements in total WOMAC score and WOMAC score of pain, stiffness, and function in both knees and no statistically significant difference in cartilage thickness of the knee measured by MRI. In group 2, there were statistically significant improvement in total WOMAC score and WOMAC score of pain and function in both knees, no statistically significant improvement in WOMAC score of stiffness, and no statistically significant differences in cartilage thickness of the knee measured by MRI. Comparing the two groups, intra-articular injection of HA showed significant improvement than that of PRP in the management of grade 4 knees OA. Conclusions The effect of intra-articular injection of HA is better than that of PRP in the management of grade 4 knees OA.