Prp Plus Hyaluronic Acid vs Crosslinked Hya in Knee Osteoarthritis

Key Takeaways

• At 6 months, WOMAC pain on walking favored PRP-HA, and investigators described PRP-HA as non-inferior on WOMAC pain responder assessment over 6 months.
• PASS WOMAC Pain responses favored PRP-HA, while OMERACT-OARSI and WOMAC pain MCII did not show significant between-group differences.
• Investigators described a good safety profile, and WOMAC scores improved from baseline at 12 months in both groups during the open-label extension.

At 6 months, WOMAC pain on walking favored single-injection PRP plus non-crosslinked hyaluronic acid over crosslinked hyaluronic acid in a randomized multicenter knee osteoarthritis trial. Among 156 patients with moderate symptomatic disease, the between-group difference was -6.34 points, with a 95% confidence interval of -12.51 to -0.18 and p=0.04.

The BMC Musculoskeletal Disorders trial report compared the platelet-rich plasma combination with Synvisc-One, a crosslinked hyaluronic acid, as single intra-articular injections. The trial compared two one-time intra-articular approaches for moderate symptomatic knee osteoarthritis over the prespecified follow-up period. Investigators also described the regimen as non-inferior over 6 months on responder-based WOMAC pain assessment.

Researchers conducted a single-blind, intention-to-treat, randomized controlled multicenter non-inferiority trial in patients with moderate symptomatic knee osteoarthritis. The study enrolled 156 participants and compared one intra-articular injection of autologous PRP with non-crosslinked hyaluronic acid against Synvisc-One, a crosslinked hyaluronic acid. The PRP-HA preparation used Cellular Matrix technology and the Cellular Matrix A-CP-HA Kit, and WOMAC plus SF36 were collected at 1, 3, and 6 months. Follow-up centered on repeated patient-reported measures during the initial 6-month comparison period. The comparison followed both single-injection strategies across the scheduled assessment window.

At 6 months, PASS WOMAC Pain responder rates were 50.6% with PRP-HA and 33.3% with crosslinked hyaluronic acid, with p=0.04. OMERACT-OARSI responder rates were 58% versus 48% with p=0.26, while WOMAC pain MCII rates were 44.4% versus 36.0% with p=0.29. These responder analyses used different thresholds and should not be read as interchangeable outcomes within the same 6-month dataset. Investigators concluded PRP-HA was non-inferior to crosslinked hyaluronic acid for the percentage of WOMAC pain responders over 6 months. That pattern accompanied the significant pain-on-walking advantage at month 6, although results were mixed across endpoints.

Patients who remained symptomatic at 6 months could enter a 6-month open-label extension. The extension was limited to those who were still symptomatic at the 6-month visit in either randomized group. During that phase, a single PRP-HA injection was offered to participants from both original groups. WOMAC improved at 12 months compared with baseline in both groups, and investigators described PRP-HA as having a good safety profile.