Evidence map›Paper›PMID 40498171›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Intra-articular injections of platelet-rich plasma combined with hyaluronic acid versus platelet-rich plasma alone in the treatment of knee osteoarthritis: a systematic review and meta-analysis.

Narata Yudtanahiran, Phisitphong Piyapanyamongkhon, Waranyoo Rojpalakorn, Thun Itthipanichpong, Danaithep Limskul, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Napatpong Thamrongskulsiri

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Narata YudtanahiranMedical Student, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Phisitphong PiyapanyamongkhonMedical Student, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Waranyoo RojpalakornMedical Student, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Thun ItthipanichpongSports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Thailand, Bangkok, Thailand.
Danaithep LimskulSports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Thailand, Bangkok, Thailand.
Thanathep TanpowpongSports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Thailand, Bangkok, Thailand.
Somsak KuptniratsaikulDepartment of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Napatpong ThamrongskulsiriSports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Thailand, Bangkok, Thailand. napatpong.tha@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/

aimThis study aimed to evaluate the efficacy and safety of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) compared to PRP alone in treating knee osteoarthritis (OA). METHODOLOGY: A systematic review and meta-analysis were conducted according to the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. PubMed, Scopus, and Cochrane Library databases were searched for studies comparing PRP + HA to PRP alone in knee OA patients. Data on patient-reported outcomes, adverse events, and study quality were extracted.

resultsNine studies (n = 868 knees) met inclusion criteria. PRP + HA statistically significantly improved The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function, and total scores compared to PRP alone (p < 0.05), though differences were below the minimal clinically important difference (MCID). No significant differences were found in WOMAC pain, stiffness, visual analog scale (VAS) for pain, or Knee Injury and Osteoarthritis Outcome score (KOOS) between groups. Adverse events were more frequent in the PRP group (24.6%) than the PRP + HA group (15.4%), with all events being minor and self-limiting.

conclusionThere were no statistically significant differences between intra-articular PRP combined with HA and PRP alone in terms of WOMAC for pain and stiffness, VAS for pain, and KOOS. However, the combination therapy resulted in statistically significant lower WOMAC scores for physical function and total compared to PRP alone, though the differences were minimal and below the MCID.

Indexed as

Hyaluronic AcidOsteoarthritis, KneePlatelet-Rich PlasmaViscosupplementsCombined Modality TherapyHumansInjections, Intra-ArticularPain MeasurementTreatment OutcomeHyaluronic AcidViscosupplementsHyaluronic acidIntra-articular injectionsKnee osteoarthritisMeta-analysisPlatelet-rich plasma

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.