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Cited by 10Osteoarthritis Treatment and MechanismsPeriodontal Regeneration and TreatmentsMusculoskeletal pain and rehabilitation

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The Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review

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Pojala, Ciprian Vasile, Toma, Sebastian, Costache, Cristea, Peter, Tunde, Pojala, Cristiana Elena, Roman, Nadinne Alexandra, Dima, Lorena·2024·Clinics and Practice
DOI 10.3390/clinpract14050157PMC PMC11506573
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Abstract

Background: Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients’ quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA. Methods: A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes. Results: The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results. Conclusions: Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.

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  • PRP appears to have limited benefit in Achilles tendinopathy and knee osteoarthritis, where trials reported no significant improvement over placebo.

    “PRP also appears to have limited benefit in certain conditions, such as Achilles tendinopathy and knee osteoarthritis, where trials have reported no significant improvement over placebo [109].”

    From Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications (2025) · cites this paper as [109]

    The Results (§3.3; page unavailable) describe substantial improvements in pain and function with PRP for knee osteoarthritis, and the Discussion (§4.2; page unavailable) reports benefits over hyaluronic acid. This runs contrary to the claim of limited benefit for knee osteoarthritis, although the review does not establish the specific placebo comparison. The retrieved passages do not address Achilles tendinopathy. (LLM, conf=0.84)

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  • PRP administered with hyaluronic acid or MSCs enhances regenerative capacity, particularly in knee osteoarthritis and cartilage repair.

    “Studies have explored PRP administered with hyaluronic acid (HA) or MSCs to enhance regenerative capacity, particularly in knee osteoarthritis and cartilage repair [109].”

    From Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications (2025) · cites this paper as [109]

    Section 4.2 reports that PRP combined with HA improved pain and function in knee osteoarthritis, and separately discusses PRP’s potential to promote cartilage repair. It does not establish that the HA combination enhances cartilage regeneration. The Introduction mentions MSC treatment separately; although the References list a trial of MSCs with PRP, the cited passages do not report its findings or support an enhanced regenerative effect from that combination. (LLM, conf=0.87)

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Metadata

Authors
Pojala, C. V., Toma, S., Costache, C., Peter, T., Pojala, C. E., Roman, N. A., & Dima, L.
Affiliations
  • University of Medicine and Pharmacy of Craiova (RO)
  • Transilvania University of Brașov (RO)
Corresponding author
Roman, Nadinne Alexandra
ORCID
Venue
Clinics and Practice
Publisher
MDPI AG
Published
2024-09-25
Volume
14
Issue
5
Pages
1970-1996
ISSN
  • 2039-7275 (ISSN-L)
  • 2039-7283
DOI
10.3390/clinpract14050157
PMC
PMC11506573
OpenAlex
W4402922478
Cited by
10
References
5
Citations by year
2026: 4 · 2025: 6
FWCI
0.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinics and Practice (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords
knee osteoarthritis, intra-articular therapy, hyaluronic acid, platelet-rich plasma, analgesia, joint function, treatment efficacy, treatment safety, high molecular weight hyaluronic acid, combination therapy

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