Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

Clin Rheumatol. 2020 Oct;39(10):3057-3064. doi: 10.1007/s10067-020-05121-4. Epub 2020 May 1.

Abstract

Introduction/objectives: Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane® (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA.

Method: Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up.

Results: Mean age was 55.8 ± 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p < 0.05). There were no statistically significant differences between the groups in terms of first week pain relief (p > 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group's rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group.

Conclusion: As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group. Key Points • The short-term effects of intra-articular HA, peptide, and PRP injections were compared in knee osteoarthritis. • HA, peptide, and PRP injections may be useful in pain relief and functional improvement in knee osteoarthritis.

Keywords: Hyaluronic acid; Intra-articular injections; Knee osteoarthritis; Peptide molecules; Platelet-rich plasma.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Female
  • Humans
  • Hyaluronic Acid / therapeutic use
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Ontario
  • Osteoarthritis, Knee* / drug therapy
  • Peptides / therapeutic use
  • Platelet-Rich Plasma*
  • Treatment Outcome

Substances

  • Peptides
  • Hyaluronic Acid