REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
The efficacy and safety of platelet rich plasma and hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis
Provisionally accepted
- 1Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, Hohhot, China
- 2The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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Purpose: To investigate the efficacy and safety of intra-articular injection ratio of platelet rich plasma (PRP) and hyaluronic acid (HA), and provide evidence-based strategies for the treatment of knee osteoarthritis (KOA). Methods: Search PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases to retrieve literature published from the beginning of database establishment to October 2024. Include in published randomized controlled trials (RCTs) or cohort studies. The research subjects are KOA patients, with the experimental group receiving intra-articular injection of PRP and the control group receiving intra-articular injection of HA. Quality evaluation of the inclusion of Cochrane Handbook risk assessment tools using RevMan5 Perform meta-analysis on outcome measures using three software. Results: 18 articles were included, with a total of 1326 patients. PRP showed significantly better WOMAC scores at 6 months (SMD=-8.32, P<0.0001) and 12 months (SMD=-3.15, P<0.0001), superior IKDC scores at 6 months (SMD=0.85, P=0.004), and greater pain reduction on VAS at 3 months (SMD=-0.56, P<0.0001) and 6 months (SMD=-0.85, P<0.0001). EQ-VAS scores also favored PRP at 2 months (SMD=0.20, P=0.04) and 12 months (SMD=0.35, P=0.001). No significant differences were found in adverse events (OR=1.31, P=0.21) or patient satisfaction (MD=1.60, P=0.08), indicating comparable safety profiles. Conclusion: PRP has a good clinical therapeutic effect on KOA. Based on this meta-analysis, compared with simple intra-articular injection of HA, PRP can improve WOMAC score, VAS score, and IKDC index score after 6 months of treatment, and enhance patients' health status. In terms of the incidence of adverse events, the safety of the two treatment options is similar.
Keywords: Hyaluronic Acid, knee osteoarthritis, Meta, Meta-analysis, Platelet rich plasma
Received: 15 Oct 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 An, Wu, Wang, Zhang, Yan, Wu, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianzhong Wang
Haibin Zhang
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