Clinical effectiveness in severe knee osteoarthritis after intra-articular platelet-rich plasma therapy in association with hyaluronic acid injection: three case reports

Figures & data

Table 1 The characteristics of the three cases, before and after treatment

	Before PRP + HA				After PRP + HA
	VAS (mm)	Lequesne index	WOMAC index	JSW (right/left) (mm)	VAS (mm)	Lequesne index	WOMAC index	JSW (right/left) (mm)
Case 1	85	11	77	0.30/0.21	23	7	34	0.91/0.52
Case 2	87	14	88	0.32/0.46	30	8	30	0.60/0.49
Case 3	81	16	64	0.55/1.09	0	0	0	5.5/5.2

Notes: VAS is 0–100 (100 is most pain); Lequesne index ranges from 0 to 24 (24 is extremely serious); WOMAC index ranges from 0 to 96 (high score is severe symptoms/worse function); JSW is the minimal joint space width in the medial compartment of knees.

Abbreviations: HA, hyaluronic acid; JSW, joint space width; PRP, platelet-rich plasma; VAS, visual analog scale; WOMAC, Western Ontario and McMaster Universities Osteoarthritis.

Figure 1 Standard weight-bearing knee X-rays of a 77-year-old female before (A) and 8 months after (B) one course of intra-articular PRP in association with HA injection, showing the increase in medial joint space (white arrows).

Abbreviations: HA, hyaluronic acid; PRP, platelet-rich plasma.

Figure 2 Standard weight-bearing knee X-rays of a 69-year-old female before (A) and 15 months after (B) one course of intra-articular PRP in association with HA injection, showing significant improvement in the narrowing joint space (white arrows).

Abbreviations: HA, hyaluronic acid; PRP, platelet-rich plasma.

Figure 3 Standard weight-bearing knee X-rays of a 76-year-old female before (A) and 1 year after (B) two courses of intra-articular PRP in association with HA injection, showing more significant bone spur growth and the cartilage remains at a healthy size with the normal joint space (white arrows).

Abbreviations: HA, hyaluronic acid; PRP, platelet-rich plasma.