Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial

Background: Knee osteoarthritis (KOA) can be effectively treated conservatively using platelet-rich plasma (PRP) injections into the affected joints. While the short-term therapeutic clinical benefits were well documented, the mid-term results remain undetermined. To clarify its efficacy, the mid-te...

Full description

Bibliographic Details
Main Authors: Zhengming Wang, Rui Wang, Sicheng Xiang, Yong Gu, Ting Xu, Hengkai Jin, Xinbo Gu, Peijian Tong, Hongsheng Zhan, Shuaijie Lv
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-11-01
Series:Frontiers in Bioengineering and Biotechnology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fbioe.2022.1062371/full
_version_ 1811186632201601024
author Zhengming Wang
Zhengming Wang
Rui Wang
Sicheng Xiang
Yong Gu
Ting Xu
Hengkai Jin
Xinbo Gu
Peijian Tong
Hongsheng Zhan
Hongsheng Zhan
Shuaijie Lv
author_facet Zhengming Wang
Zhengming Wang
Rui Wang
Sicheng Xiang
Yong Gu
Ting Xu
Hengkai Jin
Xinbo Gu
Peijian Tong
Hongsheng Zhan
Hongsheng Zhan
Shuaijie Lv
author_sort Zhengming Wang
collection DOAJ
description Background: Knee osteoarthritis (KOA) can be effectively treated conservatively using platelet-rich plasma (PRP) injections into the affected joints. While the short-term therapeutic clinical benefits were well documented, the mid-term results remain undetermined. To clarify its efficacy, the mid-term clinical outcomes of intra-articular injections of either PRP or hyaluronic acid (HA) in KOA were compared.Methods: One hundred patients who complied with the inclusion criteria were randomized to undergo once a week 3 weeks, intra-articular injections of either PRP or HA. Patients were evaluated before the injection, at 3, 6, and a mean of 78.9 months of follow-up. Eighty-five patients reached the final evaluation. Data on survival, re-intervention, pain, function, imaging, and satisfaction were collected and analyzed.Results: With surgery for any reason as the endpoint, the cumulative survival rate of the PRP group was 90%, while that of the HA group was 74%. There was a significant difference between the two groups in the total re-intervention rate (56.7% vs 16.2%, p < 0.05). The comparative analyses showed significant intergroup differences in the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) (p < 0.01, p < 0.05, respectively) at the final follow-up. And base on the regression analyses, the type of treatment, age, and Kellgren-Lawrence (K-L) grade served as statistically an independent determinants of VAS (p < 0.001, p = 0.034, p < 0.001, respectively). Likewise, those variables independently determined WOMAC in our study. However, no difference was observed in the imaging evaluation, containing the K-L grade and Cartilage Lesion Score, between the two groups (p > 0.05). Besides, the satisfaction treated by the PRP was 78.6%, with a superiority compared with HA (55.8%, p < 0.05), and no complications were noted in the whole treatment process among patients who participated.Conclusion: PRP was more effective than HA in survival and re-intervention rates, VAS, and WOMAC, although there were no significant differences in the imaging evaluation between the two groups. Furthermore, patients treated with PRP were associated with higher satisfaction compared with HA.
first_indexed 2024-04-11T13:48:39Z
format Article
id doaj.art-a0de58890f2b47fb9a384ce6f4817253
institution Directory Open Access Journal
issn 2296-4185
language English
last_indexed 2024-04-11T13:48:39Z
publishDate 2022-11-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Bioengineering and Biotechnology
spelling doaj.art-a0de58890f2b47fb9a384ce6f48172532022-12-22T04:20:50ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-11-011010.3389/fbioe.2022.10623711062371Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trialZhengming Wang0Zhengming Wang1Rui Wang2Sicheng Xiang3Yong Gu4Ting Xu5Hengkai Jin6Xinbo Gu7Peijian Tong8Hongsheng Zhan9Hongsheng Zhan10Shuaijie Lv11Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang, ChinaShi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaThe First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang, ChinaBackground: Knee osteoarthritis (KOA) can be effectively treated conservatively using platelet-rich plasma (PRP) injections into the affected joints. While the short-term therapeutic clinical benefits were well documented, the mid-term results remain undetermined. To clarify its efficacy, the mid-term clinical outcomes of intra-articular injections of either PRP or hyaluronic acid (HA) in KOA were compared.Methods: One hundred patients who complied with the inclusion criteria were randomized to undergo once a week 3 weeks, intra-articular injections of either PRP or HA. Patients were evaluated before the injection, at 3, 6, and a mean of 78.9 months of follow-up. Eighty-five patients reached the final evaluation. Data on survival, re-intervention, pain, function, imaging, and satisfaction were collected and analyzed.Results: With surgery for any reason as the endpoint, the cumulative survival rate of the PRP group was 90%, while that of the HA group was 74%. There was a significant difference between the two groups in the total re-intervention rate (56.7% vs 16.2%, p < 0.05). The comparative analyses showed significant intergroup differences in the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) (p < 0.01, p < 0.05, respectively) at the final follow-up. And base on the regression analyses, the type of treatment, age, and Kellgren-Lawrence (K-L) grade served as statistically an independent determinants of VAS (p < 0.001, p = 0.034, p < 0.001, respectively). Likewise, those variables independently determined WOMAC in our study. However, no difference was observed in the imaging evaluation, containing the K-L grade and Cartilage Lesion Score, between the two groups (p > 0.05). Besides, the satisfaction treated by the PRP was 78.6%, with a superiority compared with HA (55.8%, p < 0.05), and no complications were noted in the whole treatment process among patients who participated.Conclusion: PRP was more effective than HA in survival and re-intervention rates, VAS, and WOMAC, although there were no significant differences in the imaging evaluation between the two groups. Furthermore, patients treated with PRP were associated with higher satisfaction compared with HA.https://www.frontiersin.org/articles/10.3389/fbioe.2022.1062371/fullosteoarthritisplatelet-rich plasmahyaluronic acidkneeintra-articular injection
spellingShingle Zhengming Wang
Zhengming Wang
Rui Wang
Sicheng Xiang
Yong Gu
Ting Xu
Hengkai Jin
Xinbo Gu
Peijian Tong
Hongsheng Zhan
Hongsheng Zhan
Shuaijie Lv
Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
Frontiers in Bioengineering and Biotechnology
osteoarthritis
platelet-rich plasma
hyaluronic acid
knee
intra-articular injection
title Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
title_full Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
title_fullStr Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
title_full_unstemmed Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
title_short Assessment of the effectiveness and satisfaction of platelet-rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7-year follow-up: A post hoc analysis of a randomized controlled trial
title_sort assessment of the effectiveness and satisfaction of platelet rich plasma compared with hyaluronic acid in knee osteoarthritis at minimum 7 year follow up a post hoc analysis of a randomized controlled trial
topic osteoarthritis
platelet-rich plasma
hyaluronic acid
knee
intra-articular injection
url https://www.frontiersin.org/articles/10.3389/fbioe.2022.1062371/full
work_keys_str_mv AT zhengmingwang assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT zhengmingwang assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT ruiwang assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT sichengxiang assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT yonggu assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT tingxu assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT hengkaijin assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT xinbogu assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT peijiantong assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT hongshengzhan assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT hongshengzhan assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial
AT shuaijielv assessmentoftheeffectivenessandsatisfactionofplateletrichplasmacomparedwithhyaluronicacidinkneeosteoarthritisatminimum7yearfollowupaposthocanalysisofarandomizedcontrolledtrial