Treatment of knee osteoarthritis with mixture of platelet-rich-plasma plus hyaluronic acid

Objective To compare the clinic effects of intra-knee-articular injection of PRP+ HA mixture and PRP only on treating grade Ⅱand Ⅲ knee osteoarthritis. Methods A total of 126 qualified patients with grade Ⅱ and Ⅲknee osteoarthritis according to Keligren Lawrence classification(K-L classification ) in Weihai Municipal Hospital and Shandong Provincial hospital from February 2014 to May 2014 were included: Exclusion criteria were other knee inflammatory diseases, any bone and joint tumors, history of hormone usage, and severe cardiovascular diseases and diabetes. There were 63 cases in the PRP+ HA mixture group and 63 cases in the PRP group. The pain was evaluated by visual analogue scale (VAS), and the joint function was assessed with Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). The t-test was used to asscesse the difference of age, body mass index(BMI), visual analogue score (VAS) and WOMAC scores; chi-square test was used to evaluate the difference of gender, K-L classification. Follow-up was carried out at one, three, six and 12 months. VAS score and WOMAC score were assessed the patients’ condition. The t test was used to compare the curative effect at different time points after the treatment. Results There was no significant difference between the two groups in gender, age, or BMI (all P>0.05). In the participants treated with PRP+ HA mixture and with PRP only, VAS scores decreased significantly, and accordingly, knee function (WOMAC) improved, compared to the status of patients prior to treatment. Regarding to VAS and WOMAC, no significant difference was observed between the two groups (VAS: t=0.862, P>0.05; WOMAC: t=1.765, P>0.05); however, there was a trend that could obtain better functional scores in PRP+ HA mixture group. No major adverse events or complications were observed in both groups. Conclusion PRP+ HA mixture is effective and safe in the management of patients suffering from grade Ⅱ and Ⅲ KOA. Key words: Osteoarthritis; Platelet rich plasma; Hyaluronic acid