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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EProspective randomized data show significantly improved pain and function at 6 months for patients with osteoarthritis treated by intra-articular injections with either hyaluronic acid or platelet-rich plasma. Use of platelet-rich plasma may be more beneficial to treat active patients based on significant improvement in the International Knee Documentation Committee score.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eosteoarthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehyaluronic acid\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eplatelet-rich plasma\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInternational Knee Documentation Committee\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Evisual analog scale\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELysholm knee scale\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epain management\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopedic procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003EEmerging biochemical research suggests that platelet-rich plasma (PRP) is a biologic alternative to hyaluronic acid (HA) and may alter the intra-articular biologic environment in patients with osteoarthritis (OA) to help mitigate their symptoms [Chen WH et al. \u003Cem\u003EBiomaterials.\u003C\/em\u003E 2014]. To examine this, Brian J. Cole, MD, Rush University Medical Center, Chicago, Illinois, USA, and colleagues conducted a double-blind, prospective, randomized clinical trial that compared the effects of PRP with HA for the treatment of OA in the knee. Patients with OA treated with intra-articular injections of either HA or PRP showed significant improvement in pain and function at 6 months. The study also showed that for active patients, PRP may be superior to HA, as suggested by a significant improvement in the International Knee Documentation Committee (IKDC) score.\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003EThe study included 111 patients (53 men; 58 women) randomized to either HA or PRP. The mean age of patients was 56.2 years. All patients had a minimum of 3 months of symptomatic unilateral knee OA and Kellgren\u2013Lawrence grade 1 to 3 OA.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003EPatients in each treatment cohort received 3 weekly ultrasound-guided injections of their respective treatment (either HA or PRP). Following their index treatment, patients in each cohort were seen again and assessed at weeks 6, 12, and 24 by clinical examination and by completing a survey that included a number of measures: the Lysholm knee scale, the IKDC score, the Western Ontario and McMaster Universities Osteoarthritis Index, and the visual analog scale (VAS) for pain.\u003C\/p\u003E\n\u003Cp id=\u0022p-5\u0022\u003EAt these time intervals, as well as at 3- and 6-month follow-up, patients also underwent ultrasound-guided knee aspiration for synovial fluid analysis. Using an enzyme-linked immunosorbent assay, synovial fluid was grouped and analyzed for catabolic factors.\u003C\/p\u003E\n\u003Cp id=\u0022p-6\u0022\u003EOf the 111 patients, 11 (9.9%) were lost to follow-up or were unwilling to complete the study.\u003C\/p\u003E\n\u003Cp id=\u0022p-7\u0022\u003EThe study found that patients in both cohorts had a significant improvement from the index visit to 6 months after treatment based on all scales measured (\u003Cem\u003EP\u2005\u003C\/em\u003E\u0026lt;\u2005.01). Patients who received PRP, however, showed a significantly higher IKDC score at 6 months compared with patients who received HA (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.02; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). According to Dr Cole, the significant improvement in IKCD score suggests that PRP is superior to HA in active patients as this scoring system uses active participation in strenuous sports as its upper limit.\u003C\/p\u003E\n\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Higher IKDC Score in Patients Treated With PRP vs HAACP, autologous conditioned plasma; HA, hyaluronic acid; IKDC, International Knee Documentation Committee; PRP, platelet-rich plasma.Reproduced with permission from BJ Cole, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-141962020\u0022 data-figure-caption=\u0022Higher IKDC Score in Patients Treated With PRP vs HAACP, autologous conditioned plasma; HA, hyaluronic acid; IKDC, International Knee Documentation Committee; PRP, platelet-rich plasma.Reproduced with permission from BJ Cole, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16261\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EHigher IKDC Score in Patients Treated With PRP vs HA\u003C\/p\u003E\n\u003Cp id=\u0022p-9\u0022\u003EACP, autologous conditioned plasma; HA, hyaluronic acid; IKDC, International Knee Documentation Committee; PRP, platelet-rich plasma.\u003C\/p\u003E\n\u003Cp id=\u0022p-10\u0022\u003EReproduced with permission from BJ Cole, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-11\u0022\u003EThe study also found a significantly lower VAS pain score in patients treated with PRP compared with HA (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.01; \u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E).\u003C\/p\u003E\n\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Lower VAS Pain Score With PRP vs HAACP, autologous conditioned plasma; HA, hyaluronic acid; PRP, platelet-rich plasma; VAS, visual analog scale.Reproduced with permission from BJ Cole, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-141962020\u0022 data-figure-caption=\u0022Lower VAS Pain Score With PRP vs HAACP, autologous conditioned plasma; HA, hyaluronic acid; PRP, platelet-rich plasma; VAS, visual analog scale.Reproduced with permission from BJ Cole, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/13\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16262\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003ELower VAS Pain Score With PRP vs HA\u003C\/p\u003E\n\u003Cp id=\u0022p-13\u0022\u003EACP, autologous conditioned plasma; HA, hyaluronic acid; PRP, platelet-rich plasma; VAS, visual analog scale.\u003C\/p\u003E\n\u003Cp id=\u0022p-14\u0022\u003EReproduced with permission from BJ Cole, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-15\u0022\u003ESynovial analysis showed significantly higher interleukin-6 concentrations in PRP-treated patients compared with HA-treated patients at 6 months (\u003Cem\u003EP\u2005\u003C\/em\u003E=\u2005.02), but no differences between the cohorts was seen in other catabolic factors analyzed.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}