The Outcome of Intra-Articular Injections of Platelets Rich Plasma with Hyaluronic Acid in Osteoarthritis of Knee

Outcome of Intra-Articular Injections of Platelets Rich Plasma with Hyaluronic Acid in Osteoarthritis of Knee

Abstract

Introduction:

Knee osteoarthritis (KOA) is a degenerative joint disorder characterized by pain, stiffness, and reduced function. Intra-articular injections of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) (Cellular Matrix^TM PRP-HA) have emerged as promising nonsurgical treatment options aimed at improving symptoms and delaying disease progression.

Objective:

To evaluate the clinical outcomes and safety profile of intra-articular PRP combined with HA in patients with KOA.

Methods:

This longitudinal, single-centre study was conducted at the Department of Rheumatology, Fatima Memorial Hospital, over a six-month period. A total of 20 patients aged 40–75 years with radiographically confirmed KOA (Kellgren–Lawrence grades I–IV) were enrolled via purposive sampling. Each patient received two intra-articular injections of PRP combined with HA prepared with cellular matrix tube in a specialized centrifuge machine on days 1 and 90. Functional and pain outcomes and difficulty scores were asssessed via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), and other clinical parameters at three time points: baseline and 90 and 90 days post after the final injection (Day 180). Repeated measures ANOVA was used for statistical analysis.Adverse effects were minimal, with only 3 patients (15%) reporting mild, transient symptoms.

Results:

Statistically significant improvements were observed in most functional activities and clinical scores. The difficulty scores assessed by WOMAC and VAS decreased from 49.30 ± 5.89 to 29.95 ± 15.40 (F = 13.12, p < 0.0001), the pain scores decreased from 14.05 ± 2.56 to 8.50 ± 4.47 (F = 10.85, p = 0.0001), and the VAS scores decreased from 7.40 ± 1.23 to 4.10 ± 1.52 (F = 29.55, p < 0.0001). The WOMAC score improved from 69.10 ± 7.60 to 41.90 ± 20.38 (F = 14.32, p < 0.0001). The radiological grade remained unchanged (p = 0.135). Adverse effects were minimal, with only 3 patients (15%) reporting mild, transient symptoms.

Conclusion:

PRP combined with HA significantly reduces pain and improves functional outcomes in patients with KOA, with an excellent safety profile, making it a viable alternative to surgical intervention in selected cases.

Keywords:
Knee osteoarthritis, Platelet-rich plasma, Hyaluronic acid, Intra-articular injection, Functional outcomes