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Updated: Sep 28, 2025
Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
Intra-articular injection with platelet-rich plasma compared to triamcinolone hexacetonide or saline solution in knee
José Carlos Nunes-Tamashiro1, Jamil Natour2, Fernando Maier Ramuth1
1Academic of Rheumatology Division, 58804from Universidade Federal de São Paulo- Escola Paulista de Medicina (Unifesp - EPM), Sao Paulo, Brazil.
Objectives:
To compare the effectiveness of intra-articular injection (IAI) of Platelet-Rich Plasma (PRP) with Triamcinolone Hexacetonide (TH) and Saline Solution (SS), in patients with knee osteoarthritis (OA).
Design:
A randomized controlled trial, with blinded patients and assessor.
Setting:
Outpatient rheumatology service.
Subjects:
Patients with knee osteoarthritis grades II and III.
Interventions:
Patients received IAI with PRP, 40 mg TH, or SS.
Methods:
Patients were assessed at baseline and after 4, 8, 12 e 52 weeks with: visual analogue scale (VAS) for pain at rest and movement, WOMAC questionnaire, Timed to Up and Go test, 6-min walk test, percentage of improvement, goniometry, quality of life SF-36 questionnaire, Likert scale and Kelgreen & Lawrence (KL) radiographic scale (only at baseline and 52 weeks).
Results:
100 patients were studied, with a mean age of 67.13(6.56) years. The TH group was superior for: percentage of improvement (versus SS group from 4 to 52 weeks); WOMAC total and pain (versus PRP group at 4 weeks); and WOMAC stiffness (versus SS group at 12 weeks). The SS group was inferior for WOMAC function (from 8 to 52 weeks). The PRP group showed lowest radiographic progression [TH 17 (51.51%) to 24 (72.72%); SS 17 (51.51%) to 30 (90.90%); PRP 20 (58.82%) to 21 (61.76%)].
Conclusion:
The Triamcinolone Hexacetonide group was superior for percentage of improvement and WOMAC, pain and stiffness. For the WOMAC function, the Platelet-Rich Plasma group and Triamcinolone Hexacetonide group were superior to the Saline group. The Platelet-Rich Plasma group showed the lowest radiographic progression at 52 weeks of follow-up.
