Abstract
Purpose: To evaluate the difference in clinical efficacy of platelet-rich plasma (PRP) versus
hyaluronic acid (HA) in the treatment of knee osteoarthritis (KOA).
Methods: This study conducted a comprehensive search of the Cochrane Library, Web of Science,
PubMed, CNKI, Wanfang Data, and VIP databases. Eligible studies underwent rigorous quality
assessment using the Cochrane Handbook 8.2 Risk of Bias 2 criteria. A meta-analysis of efficacy-
related indicators was performed using RevMan 5.4 software.
Results: Fifteen double-blind randomized controlled trials comprising 1,632 patients with KOA
ranging from I to III on the Kellgren-Lawrence grading scale were included. Meta-analysis revealed
that the PRP group exhibited significantly lower Western Ontario and McMaster Universities
Osteoarthritis Index pain scores and total scores from baseline compared to the HA group at 12
months (MD = -1.14; 95% CI, -2.09 to -0.20; P = .02; MD = -7.33; 95% CI, -12.81 to -1.85; P = .009,
respectively), both of which reached the minimal clinically important difference. Visual analog scale
scores were also significantly reduced in the PRP group at 12 months (mean difference [MD] =
-0.35; 95% CI, -0.59 to -0.10; P = .005, respectively). Improved International Knee Documentation
Committee scores were observed in the PRP group at 1 month (MD = 3.13; 95% CI, 1.34-4.93; P =
.0006, respectively).
Conclusions: After 12 months, there were statistically significant differences in Western Ontario
and McMaster Universities Osteoarthritis Index pain and total scores, as well as minimal clinically
important differences, with PRP being superior to HA in the treatment of KOA.
Level of evidence: Level II, meta-analysis of Level I and II studies.
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