Ron Gilat1,2, Eric D Haunschild1, Derrick M Knapik3, Aghogho Evuarherhe1, Kevin C Parvaresh1, Brian J Cole4. 1. Midwest Orthopaedics at Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612, USA. 2. Department of Orthopaedic Surgery, Shamir Medical Center and Tel Aviv University, Tel Aviv, Israel. 3. Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 4. Midwest Orthopaedics at Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612, USA. brian.cole@rushortho.com.
Abstract
PURPOSE: Symptomatic knee osteoarthritis (OA) remains a substantial cause of pain and disability worldwide and effective management in young patients without indications for total knee arthroplasty remains challenging. Intra-articular injections represent a viable option in the non-operative treatment of knee OA. Hyaluronic acid (HA) and platelet-rich plasma (PRP) are two commonly utilized intra-articular treatment modalities that are of particular clinical interest in the current literature. The purpose of this manuscript is to provide a concise review of the current literature on the use of HA, PRP, and HA-PRP conjugates for the treatment of symptomatic knee OA. METHODS: A review of the literature utilizing PubMed, OVID/Medline, and Cochrane databases on basic science and clinical literature pertaining to preparation, composition, and outcomes of HA, PRP, and HA-PRP conjugates in patients with symptomatic knee OA. RESULTS: Both HA and PRP have been shown to be efficacious for the treatment of symptomatic knee OA, with HA injections providing limited short-term improvement, while PRP may provide greater therapeutic relief, particularly with the use of leukocyte-poor (LP-PRP) formulations. Despite limited data, the combination of different formulations of HA-PRP conjugates may provide a synergistic effect, resulting in a clinically significant improvement in both pain and function. CONCLUSION: In patients with symptomatic knee OA, intra-articular HA and PRP provide short-term improvement in pain and function, while the efficacy of HA-PRP conjugates warrants further study.
PURPOSE: Symptomatic knee osteoarthritis (OA) remains a substantial cause of pain and disability worldwide and effective management in young patients without indications for total knee arthroplasty remains challenging. Intra-articular injections represent a viable option in the non-operative treatment of knee OA. Hyaluronic acid (HA) and platelet-rich plasma (PRP) are two commonly utilized intra-articular treatment modalities that are of particular clinical interest in the current literature. The purpose of this manuscript is to provide a concise review of the current literature on the use of HA, PRP, and HA-PRP conjugates for the treatment of symptomatic knee OA. METHODS: A review of the literature utilizing PubMed, OVID/Medline, and Cochrane databases on basic science and clinical literature pertaining to preparation, composition, and outcomes of HA, PRP, and HA-PRP conjugates in patients with symptomatic knee OA. RESULTS: Both HA and PRP have been shown to be efficacious for the treatment of symptomatic knee OA, with HA injections providing limited short-term improvement, while PRP may provide greater therapeutic relief, particularly with the use of leukocyte-poor (LP-PRP) formulations. Despite limited data, the combination of different formulations of HA-PRP conjugates may provide a synergistic effect, resulting in a clinically significant improvement in both pain and function. CONCLUSION: In patients with symptomatic knee OA, intra-articular HA and PRP provide short-term improvement in pain and function, while the efficacy of HA-PRP conjugates warrants further study.
Authors: Reva C Lawrence; David T Felson; Charles G Helmick; Lesley M Arnold; Hyon Choi; Richard A Deyo; Sherine Gabriel; Rosemarie Hirsch; Marc C Hochberg; Gene G Hunder; Joanne M Jordan; Jeffrey N Katz; Hilal Maradit Kremers; Frederick Wolfe Journal: Arthritis Rheum Date: 2008-01
Authors: Peter Jüni; Stephan Reichenbach; Sven Trelle; Beatrice Tschannen; Simon Wandel; Beat Jordi; Maya Züllig; Reto Guetg; Hans Jörg Häuselmann; Hans Schwarz; Robert Theiler; Hans Rudolf Ziswiler; Paul A Dieppe; Peter M Villiger; Matthias Egger Journal: Arthritis Rheum Date: 2007-11
Authors: Félix Vilchez-Cavazos; Juan Manuel Millán-Alanís; Jaime Blázquez-Saldaña; Neri Álvarez-Villalobos; Víctor Manuel Peña-Martínez; Carlos Alberto Acosta-Olivo; Mario Simental-Mendía Journal: Orthop J Sports Med Date: 2019-12-16