Bone Marrow Stem Cell Concentrate, Platelet Rich Plasma (PRP) and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-Analysis. February 2024.
New February 2024 study looks to compare the efficacy of common intra-articular joint injections used in the treatment of knee osteoarthritis, including corticosteroid (cortisone), hyaluronic acid (HA), platelet-rich plasma (PRP), and bone marrow stem cell aspirate concentrate (BMAC), with a minimum follow-up of 6-months.
Extensive literature review was conducted using the 2020 PRISMA guidelines in August 2022 in the following databases: PubMed/MEDLINE, Scopus, Cochrane Database of Controlled Trials and the Cochrane Database of Systematic Reviews. High level evidence for randomised clinical trials with a minimum follow-up of 6 months that investigated the treatments of interest were included. Patient reported outcome scores for pain and function at baseline and at latest follow-up were extracted and the change in scores were converted to uniform 0-100 scales. Arm-based Bayesian network meta-analysis using a random-effects model was created to compare the treatment arms in pain and function.
48 studies comprising a total of 9,338 knees were included. HA and PRP both led to a significant improvement in pain compared to placebo. HA, PRP, and BMAC all led to a significant improvement in function scores when compared to placebo. Surface under the cumulative ranking curves (SUCRA) of the interventions revealed that PRP, BMAC, and HA were the treatments with the highest likelihood of improvement in both pain and function with overall SUCRA scores of 91.54, 76.46, and 53.12 respectively.
This study concluded that with a minimum 6-month follow-up, PRP Injection demonstrated significantly improved pain and function for patients with chronic pain related to knee osteoarthritis compared to placebo. Additionally, PRP exhibited the highest SUCRA values for these outcomes when compared to BMAC, HA, and steroid injection.
Study can be found here.
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