Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of Knee Osteoarthritis: A systematic review and meta-analysis.
BACKGROUND
Knee osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints, knee osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and platelet-rich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis.


METHODS
Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software.


RESULTS
Seven studies with 722 subjects (364 participants in PRP and 358 participants in the HA group) were analyzed. The WOMAC PRP compared to HA, SMD = -0.75 (95% CI: -1.33 to -0.18, I2 = 92.6%) in treatment of knee osteoarthritis was statistically significant and PRP was more effective.


CONCLUSIONS
The results of this meta-analysis two years after PRP injection showed the efficacy of PRP versus HA. However, further studies are required to determine the longer-term effects.
M.Sc. of Health Technology Assessment (HTA), Department of Health Technology Assessment, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Hassan Niroomand
HN
Sadabad
Ph.D. Student of Health Policy, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Masoud
M
Behzadifar
M.D. of Orthopedics, Assistant Professor, Department of Orthopedic, Faculty of Medicine, Islamic Azad University, Mashhad, Iran.
Farzad
F
Arasteh
M.Sc. Of Epidemiology, Department of Public Health, Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabd, Iran.
Meysam
M
Behzadifar
M.D, Department of Health Technology Assessment, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Hamid Reza
HR
Dehghan
efficacy; hyaluronic acid; meta-analysis; platelet-rich plasma