Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for XXXX : A Randomized Controlled Study.

@entity1 @entity7676 @entity7245 @entity571 @entity158 @entity688 @entity65 @entity570
BACKGROUND: The effectiveness of intra-articular platelet-rich plasma ( @entity7676 ) injections has been evaluated in knee chondroplasty and @entity571 ( @entity571 ); however, little evidence of its efficacy in @entity570 exists. PURPOSE: To compare the therapeutic efficacy of autologous @entity7676 , @entity7245 ( @entity7245 ), or a combination of both ( @entity7676 + @entity7245 ) in @entity570 . STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: @entity1 aged between 18 and 65 years who were treated with outpatient surgery and who had @entity570 and @entity158 intensity at baseline of >20 on a 100-mm visual analog scale (VAS) were recruited for this study. Exclusion criteria were extensive surgery; presence of @entity65 . The primary outcome measure was a change in @entity158 intensity as assessed by the VAS at 2, 6, and 12 months after treatment. Secondary outcome measures were the Harris Hip Score, Western Ontario and McMaster Universities @entity571 Index (WOMAC), and concentration of growth factors in @entity7676 and their correlation with clinical outcomes. Clinical outcomes were evaluated by assessors and collectors blinded to the type of treatment administered. RESULTS: A total of 111 @entity1 were randomly assigned to 3 groups and received 3 weekly injections of either @entity7676 (44 @entity1 ), @entity7676 + @entity7245 (31 @entity1 ), or @entity7245 (36 @entity1 ). At all follow-ups, the @entity7676 group had the lowest VAS scores. In particular, at 6-month follow-up, the mean VAS score was 21 (95% CI, 15-28) in the @entity7676 group, 35 (95% CI, 26-45) in the @entity7676 + @entity7245 group, and 44 (95% CI, 36-52) in the @entity7245 group (P < .0005 [ @entity7676 vs @entity7245 ] and P = .007 [ @entity7676 vs @entity7676 + @entity7245 ]; F = 0.663). The WOMAC score of the @entity7676 group was significantly better at 2-month follow-up (mean, 73; 95% CI, 68-78) and 6-month follow-up (mean, 72; 95% CI, 67-76) but not at 12-month follow-up. A significant, "moderate" correlation was found between @entity688 and variations of the VAS score (r = 0.392; P = .040). Significant improvements were achieved in @entity158 and ameliorating quality of life and functional recovery. CONCLUSION: Results indicated that intra-articular @entity7676 injections offer a significant clinical improvement in @entity1 with @entity570 without relevant side effects. The benefit was significantly more stable up to 12 months as compared with the other tested treatments. The addition of @entity7676 + @entity7245 did not lead to a significant improvement in @entity158 symptoms.
