This Level 1 RCT compared leukocyte-poor PRP to hyaluronic acid (HA) for mild-to-moderate knee OA in 99 patients over 52 weeks. It measured both patient-reported outcomes and intra-articular cytokine concentrations to evaluate clinical and biological effects.
The debate over PRP vs HA for knee OA often hinges on which outcome measure you trust. This trial shows PRP wins on IKDC and VAS but not on WOMAC pain — and the choice of primary outcome matters enormously for how you interpret the literature.
When a patient with K-L grade 1-2 OA and a BMI under 30 asks about injections, this paper supports offering leukocyte-poor PRP as the preferred option over HA, with realistic counseling that benefit peaks around 6 months.
For patients with K-L grade 3 disease or obesity, both agents perform poorly. This is the group to counsel toward weight optimization or surgical planning rather than repeat injection cycles.
The 12-week cytokine data (lower IL-1β and TNF-α trending in PRP knees before clinical improvement appears) supports the anti-inflammatory mechanism of leukocyte-poor PRP and explains why preparation type matters: leukocyte-rich PRP does not show the same benefit.
This Level 1 RCT compared leukocyte-poor PRP to hyaluronic acid (HA) for mild-to-moderate knee OA in 99 patients over 52 weeks. It measured both patient-reported outcomes and intra-articular cytokine concentrations to evaluate clinical and biological effects.
The debate over PRP vs HA for knee OA often hinges on which outcome measure you trust. This trial shows PRP wins on IKDC and VAS but not on WOMAC pain — and the choice of primary outcome matters enormously for how you interpret the literature.
When a patient with K-L grade 1-2 OA and a BMI under 30 asks about injections, this paper supports offering leukocyte-poor PRP as the preferred option over HA, with realistic counseling that benefit peaks around 6 months.
For patients with K-L grade 3 disease or obesity, both agents perform poorly. This is the group to counsel toward weight optimization or surgical planning rather than repeat injection cycles.
The 12-week cytokine data (lower IL-1β and TNF-α trending in PRP knees before clinical improvement appears) supports the anti-inflammatory mechanism of leukocyte-poor PRP and explains why preparation type matters: leukocyte-rich PRP does not show the same benefit.