940 - Is Intra-Articular Leukocyte-Rich Platelet-Rich Plasma Effective for Managing Knee Osteoarthritis Pain? An Updated Systematic Review and Meta-Analysis

 Leukocyte-rich platelet-rich plasma (LR-PRP) has become a common treatment option for alleviating knee osteoarthritis (OA) pain. Nevertheless, its long-term effectiveness remains uncertain. Although numerous meta-analyses have investigated the efficacy of platelet-rich plasma (PRP) compared to hyaluronic acid (HA), studies that isolate and analyze the effects of LR-PRP alone are notably limited.

Design:

We included RCTs comparing intra-articular LR-PRP injections with HA injections for the symptomatic treatment of knee osteoarthritis, and adult participants were diagnosed with knee osteoarthritis. Two independent reviewers systematically searched electronic databases. The outcome measurements included the WOMAC total score and its subdomains (pain, physical function, and stiffness), Visual Analog Scale (VAS) scores, and adverse events. The follow-up durations ranged from 1 month to 12 months following the injection.

Results:

Nineteen RCTs involving 1,771 adults with knee osteoarthritis met the inclusion criteria. LR-PRP demonstrated no statistically significant differences in pain scores compared to HA at 1, 3, 6, and 12 months. LR-PRP does not show a significant difference in VAS scores. When comparing the LR-PRP and HA groups with WOMAC scores, we found that: the LR-PRP group showed superior outcomes in WOMAC physical function and stiffness scores at 12 months; no significant differences were observed in total WOMAC scores, WOMAC pain scores, physical function scores, or stiffness scores between the two groups at 1-, 3-, or 6-months post-injection. Additionally, there was no significant difference in the incidence of adverse events between the LR-PRP and HA groups.

Conclusions:

Intra-articular LR-PRP injections did not provide significant short-term or long-term pain relief and functional improvement compared to HA injections. Although LR-PRP showed some superiority in WOMAC physical function and WOMAC stiffness scores at 12 months, these findings remain unclear and inconclusive. Compared to previous literature, this meta-analysis does not support the superiority of LR-PRP to HA in the short-term and long-term knee OA treatment.