Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
Q: Is intra-articular platelet-rich plasma injection an effective treatment for knee OA? EVIDENCE-BASED ANSWER: PROBABLY NOT, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence suggests it is no better than placebo. Compared with saline placebo, platelet-rich plasma (PRP) injections may improve standardized scores for knee osteoarthritis (OA) pain, function, and stiffness by 24% to 70% for periods of 6 to 52 weeks in patients with early to moderate OA (strength of recommendation [SOR]: B, small randomized controlled trials [RCTs] with methodologic flaws). Compared with hyaluronic acid (HA), PRP probably improves scores by a similar amount for periods of 8 to 52 weeks (SOR: B, multiple RCTs with conflicting results favoring no difference). However, since HA alone likely doesn't improve scores more than placebo (SOR: B, RCTs of moderate quality), if both HA and PRP are about the same, then both are not better than placebo.
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