Comparative efficacy of intra-articular platelet-rich plasma, hyaluronic acid, corticosteroids, and NSAIDs for knee osteoarthritis: A retrospective cohort study

To compare the efficacy of intra-articular administration of platelet-rich plasma (PRP), hyaluronic acid (HA), corticosteroids (CS), and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis. This retrospective study analyzed 205 knees of 150 patients with Kellgren-Lawrence grade 2 to 3 knee osteoarthritis treated between 2016 and 2021. Patients received intra-articular injections of PRP, HA, CS, or NSAIDs. Visual analog scale (VAS) pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and Kellgren-Lawrence grades were assessed at baseline and final follow-up (6-12 months). All groups showed significant improvements in the VAS and WOMAC scores from baseline to the final follow-up. PRP demonstrated the greatest pain reduction (3.2 point VAS decrease) and functional improvement (20-point WOMAC decrease). HA provided moderate but consistent benefits to the patients. The CS showed rapid early improvement that diminished over time. NSAIDs showed minimal improvement. Radiographic progression was minimal in all the groups. No major adverse events were observed. PRP offered the most sustained improvement in pain and function in knee osteoarthritis, followed by that of HA. CS provide short-term relief but have limited long-term benefits. NSAIDs were the least effective treatment. These findings support a tailored approach to knee osteoarthritis treatment, using PRP and HA as promising options for long-term management. The datasets generated and/or analyzed during the current study are not publicly available but can be obtained from the corresponding author upon reasonable request. The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.Level of evidence: Diagnostic Level 3 (retrospective cohort study).