Effectiveness of Different Types of Intraarticular Injections for the Knee Osteoarthritis; a Systemic Review

Document Type : Review Article

Authors

1 orthopedic surgery Faculty of medicine – Benha University

2 MBBCH

Abstract

Background: Osteoarthritis (OA) is most prevalent type of arthritis, which significantly affects the patient’s mobility complex. The aim to evaluate the evidence from the literature regarding the superiority of platelet-rich plasma (PRP), hyaluronic acid (HA), or corticosteroids (CS) over each other's. Methods: An electronic search was coducted between January 2010 to March 2021 in different databases; PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Included randomized, nonrandomized trials that were published in English with full text available. Results: From a total 6912 screened citations, thirty studies met our inclusion criteria with a total 3303 cases. Most on included studies (N=13) compared platelet-rich plasma to hyaluronic acid and six studies compared hyaluronic acid to cortico-steroids, four studies compared hyaluronic acid to hyaluronic acid + cortico-steroids , one study compared platelet-rich plasma to cortico-steroids and another study compared platelet-rich plasma to hyaluronic acid acid , cortico-steroids. Regarding platelet-rich plasma compared to hyaluronic acid, evidence favored platelet-rich plasma over hyaluronic acid in majority of studies, the effect of platelet-rich plasma lasted longer up to 12 months, and it might be extended to 18 months if intra-osseous injection would be considered. On the other hand, hyaluronic acid should moderate efficacy over cortico-steroids injection but its effects survived only up to six months. Conclusion; platelet-rich plasma is most effective type on the long term and it provides pain relief up to 12 months especially in cases with low grades osteoarthritis and young age patients.

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