Navigating the treatment landscape: Choosing between platelet-rich plasma (PRP) and hyaluronic acid (HA) for knee osteoarthritis management – A narrative review

Abstract

Background: Knee osteoarthritis (KOA) is one of the most prevalent forms of OA and causes pain, joint instability, and functional limitations. The management of KOA involves a wide range of therapies, including surgical interventions, medications, exercise prescription, physical agent modalities, and patient education. While knee arthroplasty is an effective treatment for severe KOA, it is not suitable for younger patients or those with non-end-stage disease due to its cost and potential complications. Pharmacological therapy options for KOA include analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections, but they can have significant adverse effects. In recent years, platelet-rich plasma (PRP) and hyaluronic acid (HA) have emerged as promising treatments for KOA. Methods: We conducted a literature review to explore the effectiveness of both PRP and HA in treating knee osteoarthritis. We compared some studies to know their effectiveness in patients, when given alone and with combination. Conclusion: PRP injections have consistently outperformed HA injections in treating knee osteoarthritis, offering pain relief and improved function, but the potential benefits of combining PRP with HA remain inconclusive, necessitating further research to ascertain their effectiveness and safety in combination treatment. This narrative review serves as a guide to evidence-based treatment.

Keywords

• Knee osteoarthritis
• Platelet-rich plasma (PRP)
• Hyaluronic acid (HA)
• Growth factors
• Cartilage repair
• Intra-articular injections