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OE Original: A Guide to Different Methods of Randomization
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Platelet-rich Plasma (PRP) Versus Corticosteroid Injection for Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials

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November 14, 2022

Platelet-rich Plasma (PRP) Versus Corticosteroid Injection for Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials

Vol: 5| Issue: 11| Number:2| ISSN#: 2563-559X

Authored By: Yaping Chang, Steve Philips, Ellen Scholl, Selina Bains, Mohit Bhandari On Behalf of OrthoEvidence

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Highlights
  • In this OE Original, we conducted a systematic review and meta-analysis to examine evidence from randomized controlled trials (RCTs) comparing intra-articular (IA) injection of platelet-rich plasma (PRP) with IA injection of corticosteroids for patients with knee osteoarthritis (OA).
  • In total, 10 published RCTs were included.
  • Very low quality of evidence suggests that IA-PRP injection is associated with small benefits in pain versus IA-corticosteroids injection for patients with knee OA at 3 and 6 months of follow-up. There is no significant difference between the two groups in pain at 1-2 or 12 months of follow-up.
  • Low quality of evidence suggests that IA-PRP is associated with small benefits in function versus IA-corticosteroids injection for patients with knee OA 1-2, 6, and 12 months after intervention. There is no significant difference between the two groups in function at 3 months of follow-up with very low quality of evidence.
  • No significant differences between the PRP and corticosteroids groups were identified in incidence of adverse events at the longest follow-up.
  • Data were available for subgroup analysis by PRP dose (single versus multiple injections) at 1-2, 3, and 6 months of follow-up. No significant subgroup differences were identified in pain and function at any follow-up time points.
  • There are 45 currently ongoing studies aiming to recruit 1,785 patients that are investigating the effects of PRP or corticosteroid injection in treating knee OA according to data from clinicaltrials.gov.
Knee osteoarthritis (OA) affects about 1 in 6 people who are 15 years or older (Cui et al., 2020). Among people who are 70 years or older, the prevalence is as high as 40% (Hsu et al., 2020). Knee OA is the most common cause of chronic pain and often associated with impared function in the knee (Zhang et al., 2010). Intra-articular (IA) injection of corticosteroids is widely used and conditionally recommended for patients with knee OA, with the aim of suppressing the inflammatory response in the joint. However, the effect of corticosteroid injection ...

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T. Derek V. Cooke 2022-11-14

Orthopaedic Surgeon - Canada

There is no discussion on costs for use of PRP vs steroid. While cost information may not be available from the studies examined, cost information must be available in NA. This is, in my view, an important issue to be discussed especially since bias cannot be readily excluded.