Intra-articular hyaluronic acid and platelet-rich plasma as monotherapy or combination therapy in knee osteoarthritis?

IF 2.4 4区医学 Q4 CELL & TISSUE ENGINEERING

Regenerative medicine Pub Date : 2024-12-11 DOI:10.1080/17460751.2024.2439221

Sheng-Fei Oon, Smaro Lazarakis, Gayani Mallawa, Chau Nguyen

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引用次数: 0

Abstract

Aim: To systematically identify best current evidence on intra-articular combination therapy with hyaluronic acid (HA) and platelet-rich plasma (PRP), compared to monotherapy in knee osteoarthritis.

Methods: Using the McMaster University and National Health Service five-step systematic approach, we conducted a bottom-up literature search of all existing evidence through Ovid Medline, Ovid Embase, and Cochrane (Central - Wiley) from January 2021 to June 2024.

Results: Of 258 articles retrieved, we systematically narrowed best current evidence to one meta-analysis when evaluating combination therapy versus HA alone. This demonstrated superior outcomes with combination therapy against HA only at 3, 6, and 12 months on the visual acuity scale (VAS, p < 0.001), and with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 12 months in areas of stiffness and physical function (p < 0.001). For combination therapy versus PRP alone, one randomized controlled trial qualified as best current evidence. This demonstrated superior VAS outcomes with combination therapy compared to PRP monotherapy at 6 months (p < 0.02).

Conclusion: Best current evidence indicates that intra-articular HA and PRP as combination therapy has superior short and long term symptom control over HA or PRP as monotherapy. Due to the extensive heterogeneity in the studies, results should be interpreted with caution.

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来源期刊

Regenerative medicine 医学-工程：生物医学

CiteScore

4.20

自引率

3.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Regenerative medicine replaces or regenerates human cells, tissue or organs, to restore or establish normal function*. Since 2006, Regenerative Medicine has been at the forefront of publishing the very best papers and reviews covering the entire regenerative medicine sector. The journal focusses on the entire spectrum of approaches to regenerative medicine, including small molecule drugs, biologics, biomaterials and tissue engineering, and cell and gene therapies – it’s all about regeneration and not a specific platform technology. The journal’s scope encompasses all aspects of the sector ranging from discovery research, through to clinical development, through to commercialization. Regenerative Medicine uniquely supports this important area of biomedical science and healthcare by providing a peer-reviewed journal totally committed to publishing the very best regenerative medicine research, clinical translation and commercialization. Regenerative Medicine provides a specialist forum to address the important challenges and advances in regenerative medicine, delivering this essential information in concise, clear and attractive article formats – vital to a rapidly growing, multidisciplinary and increasingly time-constrained community. Despite substantial developments in our knowledge and understanding of regeneration, the field is still in its infancy. However, progress is accelerating. The next few decades will see the discovery and development of transformative therapies for patients, and in some cases, even cures. Regenerative Medicine will continue to provide a critical overview of these advances as they progress, undergo clinical trials, and eventually become mainstream medicine.