Comparing hyaluronic acid and platelet rich plasma injections

Article summary:
Researchers suggest that Platelet Rich Plasma Injections (PRP) are superior to hyaluronic acid injections.

  • Please visit this page for general information on Platelet Rich Plasma Injections
  • Please visit this page for information specific to PRP and knee osteoarthritis
  • Hyaluronic acid injections are marketed under the trade names: Euflexxa, Hyalgan, Orthovisc, Supartz, among others. Synvisc is a chemically modified form of  Hyaluronic acid. These treatments can also be referred to as viscosupplementation.

PRP is the preferred choice of treatment in our office. Through clinical observation we have observed the treatment’s effectiveness.

In agreement with our assessment is very recent research that simply concluded:

  • “In this study (of 118 patients), the intra-articular PRP administration was more efficient than the hyaluronic acid administration in early knee osteoarthritis.” 1 Source: International journal of clinical and experimental medicine
  • In another  newly released report doctors confirmed their findings suggesting Platelet Rich Plasma injections worked better than hyaluronic acid injections in reducing symptoms and improving quality of life in patients with knee osteoarthritis.2 Source: Clinical medicine insights. Arthritis and musculoskeletal disorders

One study not only compared hyaluronic acid and PRP injections, but multi-injections of PRP against single dose PRP.

  • Patients treated with 3 PRP injections did significantly better than those patients of the other groups for pain and movement
  • In this study one dose of PRP or hyaluronic acid showed about the same results.3 Source: Clinical neurology and neurosurgery.

Hyaluronic acid injections: More harm than good?

Recently investigators looking at the long term benefit of Hyaluronic acid injections found that while they can provide significant pain relief and improvement in activity of daily living function for patients with knee osteoarthritis, the reduction in pain and the increase in knee adduction movement may cause excessive loading on the knee joints, which may further accelerate the rate of knee degeneration4

  • Recently doctors noted that in patients with knee osteoarthritis, viscosupplementation offered a small and clinically irrelevant benefit and an increased risk for serious adverse events.5
  • In another larger study, researchers found that hyaluronic acid injections only provided a small relief to patients with osteoarthritis of the knee, but agreed that they could provoke both local reactions and serious adverse effects.6
  • And in another study, doctors found that Platelet Rich Plasma therapy improves function in patients with knee joint cartilage degenerative  and tends to be more effective than hyaluronic acid injection.7

Knee pain injections choices

At the Magaziner Center for Wellness we do not recommend Hyaluronic acid injections because we feel it is a temporary fix for knee problems caused by osteoarthritis.  Our feelings are supported by research in Arthroscopy : the journal of arthroscopic & related surgery.

“Plasma rich in growth factors showed superior short-term results when compared with hyaluronic acid in a randomized controlled trial, with a comparable safety profile, in alleviating symptoms of mild to moderate osteoarthritis of the knee.”8

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These publications were cited in this article:

1 Kilincoglu V, Yeter A, Servet E, Kangal M, Yildirim M. Short term results comparison of intraarticular platelet-rich plasma (prp) and hyaluronic acid (ha) applications in early stage of knee osteoarthritis.
Int J Clin Exp Med. 2015 Oct 15;8(10):18807-12. eCollection 2015.

2 Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, Azma K. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015 Jan 7;8:1-8. doi: 10.4137/CMAMD.S17894. eCollection 2015.

3 Görmeli G, Görmeli CA, Ataoglu B, Çolak C, Aslantürk O, Ertem K. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015 Aug 2.

4. Tang AC, Tang SF, Hong WH, Chen HC. Kinetics features changes before and after intra-articular hyaluronic acid injections in patients with knee osteoarthritis. Clin Neurol Neurosurg. 2015 Feb;129 Suppl 1:S21-6. doi: 10.1016/S0303-8467(15)30007-X.

5. Rutjes AWS, Jüni P, MD; da Costa BR, et al. Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review and Meta-analysis. Ann Intern Med. 2012 Jun 11.

6. Intra-articular hyaluronic acid injection: not for gonarthrosis. Prescrire Int. 2013 Oct;22(142):248-9.

7. Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen WS. Comparative Effectiveness of Platelet-Rich Plasma Injections for Treating Knee Joint Cartilage Degenerative Pathology: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2013 Nov 27. pii: S0003-9993(13)01212-4. doi: 10.1016/j.apmr.2013.11.006.

8. Sánchez M, Fiz N, Azofra J, et al A Randomized Clinical Trial Evaluating Plasma Rich in Growth Factors (PRGF-Endoret) Versus Hyaluronic Acid in the Short-Term Treatment of Symptomatic Knee Osteoarthritis. Arthroscopy. 2012 Aug;28(8):1070-8.