PRP vs Hialuronic Acid for the Treatment of Knee Osteoarthritis

OBJECTIVES: Knee osteoarthritis is a pathology of great prevalence and increase the cost to society due to loss of work, early retirement, and arthroplasty. In recent years, new non-surgical treatment alternatives have emerged based on intra-articular infiltrations with the aim of temporarily relieving symptoms and postponing definitive prosthetic treatment. The purpose of this work is to evaluate the effectiveness of intrarticular inyections with high molecular weight hyaluronic acid (HMWHA), low molecular weight hyaluronic acid (LMWHA) and platelet rich plasma (PRP). METHODS: Forty one patients were taken into account in this work, five infiltrations with LMWHA were applied to sixteen patients, a single infiltration of HMWHA was applied to twelve patients and thirteen patients were treated with three PRP infiltrations. According to Kellgreen Lawrence’s classification (KL), twenty three patients were grade II and eighteen patients were grade III. Patients were evaluated according to the WOMAC and KOOS Scales prior to treatment and at four months. Patients who had any surgical, infiltrative treatment or non surgical treatment of the knee and those who used any other adjuvant treatment after the infiltration were excluded from the sample. RESULTS: Patients were evaluated using the WOMAC and KOOS scales prior to infiltration and four months after treatment. Groups treated with HMWHA and those treated with PRP had the best results on both scales: Patients with grade II and III KL classification treated with PRP improved an average of 25 points on both scales. Likewise, those treated with HMWHA improved an average of 30 points and 25 points respectively. Finally, those who received LMWHA obtained an improvement of 21 points and 17 points respectively, which translates into a statistically significant result in favor of HMWHA and PRP compared to LMWHA, P < .05 CONCLUSION: These treatments are valid options for the relief of symptoms of degenerative knee osteoarthritis. The AH being the only one approved by the FDA, and the PRP through more and more serious studies, is proving its effectiveness in the treatment of this pathology. According to the results obtained, it is HMWHA that seems to be more effective in grade II osteoarthritis, in those patients with grade III osteoarthritis the results were similar for both PRP and HMWHA. On the other hand, relief was less in patients treated with LMWHA regardless of their degree of osteoarthritis.