title: Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis.
abstract: OBJECTIVE
  The aim of our study is to compare the efficacy of platelet-rich plasma (PRP) and viscosupplementation (hyaluronic acid [HA]) intra-articular injections for the treatment of knee cartilage degenerative lesions and osteoarthritis (OA).
  
  
  METHODS
  The study involved 150 patients affected by cartilage degenerative lesions and early and severe OA. Fifty symptomatic patients were treated with 3 autologous PRP intra-articular injections and were evaluated prospectively at enrollment and at 2- and 6-month follow-up. The results obtained were compared with 2 homogeneous groups of patients treated with HA injections. One group was treated with injections of high-molecular weight HA; the other group was treated with low-molecular weight (LW) HA. International Knee Documentation Committee and EQ VAS scores were used for clinical evaluation; adverse events and patient satisfaction were also recorded.
  
  
  RESULTS
  At 2 months' follow-up, the PRP and LW HA groups showed a similar improvement, with higher results compared with the high-molecular weight HA group (P < .005). At 6 months' follow-up, better results were observed in the PRP group (P < .005). PRP and LW HA treatments offered similar results in patients aged over 50 years and in the treatment of advanced OA. PRP showed a better performance compared with HA in younger patients affected by cartilage lesions or early OA.
  
  
  CONCLUSIONS
  Autologous PRP injections showed more and longer efficacy than HA injections in reducing pain and symptoms and recovering articular function. Better results were achieved in younger and more active patients with a low degree of cartilage degeneration, whereas a worse outcome was obtained in more degenerated joints and in older patients, in whom results similar to those of viscosupplementation have been observed.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Biomechanics Laboratory-III Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Kon
authors.forename: Bert
authors.initials: B
authors.lastname: Mandelbaum
authors.forename: Roberto
authors.initials: R
authors.lastname: Buda
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.forename: Marco
authors.initials: M
authors.lastname: Delcogliano
authors.forename: Antonio
authors.initials: A
authors.lastname: Timoncini
authors.forename: Pier Maria
authors.initials: PM
authors.lastname: Fornasari
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002356:Cartilage / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000628:therapy*; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016896:Treatment Outcome; D055676:Viscosupplementation / Q000379:methods*; D055675:Viscosupplements / Q000627:therapeutic use*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid