Study Summary

Twenty-six randomized controlled trials including 1650 knees with knee osteoarthritis were included in this systematic review and meta-analysis comparing platelet-rich plasma (PRP) versus hyaluronic acid (HA) injections. Pooled outcomes of interest included WOMAC total score and visual analogue scale (VAS) pain. The pooled analysis demonstrated that PRP produced superior improvements in both WOMAC and VAS scores compared with HA at 6 months and 12 months. Subgroup analysis based on platelet concentration also suggested that PRP preparations with higher platelet concentrations showed greater improvements in outcomes. Overall, the evidence suggests that PRP injections provide superior intermediate-term patient-reported outcomes compared with viscosupplementation with HA for knee osteoarthritis, although variability in PRP preparation protocols remains a limitation.