Intra-articular injection modalities have varying effects in patients with knee OA
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CHICAGO — Platelet-rich plasma injections provided pain relief for osteoarthritic knees for up to 1 year after treatment, based on a systematic literature review presented here.
Edward S. Mojica, BS, and colleagues conducted the review to investigate maximal medical improvement following knee intra-articular injections in patients with symptomatic knee OA. In addition to platelet-rich plasma — both leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP), injections they studied were corticosteroids (CS) and hyaluronic acid (HA). HA injections were designated as low, middle or high molecular weight-HA (LMW-HA, MMW-HA or HNW-HA).
“PRP seems to have long-term, sustained benefits, which appear may have an effect on WOMAC less than and up to a year,” Mojica said in a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Based on outcomes, per the VAS and WOMAC scores used in the studies analyzed, CS and HA were also found effective, according to the study abstract. However, Mojica and colleagues determined these injections lacked the same longevity of effect seen with PRP.
Researchers performed the study to glean information from the literature that would be useful to refer to during patient-physician discussions about injectables, Mojica said.
Researchers identified 79 published randomized controlled trials that met their inclusion criteria (8,761 patients). They analyzed demographics and patient-reported outcomes with the VAS and WOMAC for the studies selected.
Based on VAS scores, Mojica and colleagues found the maximum pain control was reached at 4 to 6 weeks post-injection for intra-articular injections of CS, MMW-HA and LR-PRP. The lowest VAS scores were attained by 3 months after intra-articular injection for the LMW-HA, HMW-HA and LP-PRP modalities, according to the results.
Regarding WOMAC scores, researchers found these were lowest at 4 to 6 weeks post-injection for CS and MMW-HA and they were lowest at 3 months after injection for the HMW-HA and LP-PRP injections.
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Mojica ES, et al. Paper 451. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 22-26, 2022; Chicago.
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