PRP works better than SynVisc, better in Patients with Mild Arthritis
In this corner, the world’s most commonly used biologic injectable for knee arthritis-SynVisc. In the other corner, your own platelets, a.k.a. PRP. The winner? Well a study published last week may help decide that honor. Platelet Rich Plasma (PRP) is now being used in patients with knee arthritis. However, there isn’t that much research yet published that shows it works in these patients. I blogged several months ago about a few studies showing that PRP tends to work better in patients with more mild and early arthritis than in patients with more severe arthritis and that stem cells tended to work better for patients with more severe arthritis. A more recent study adds more fuel to this fire, this time comparing Hyaluronic acid (HA) (SynVisc, OrthoVisc, Hyalgan, Supartz, etc…) to PRP for knee arthritis patients. The study involved 150 patients affected by both early and severe knee arthritis. Fifty symptomatic patients were treated with 3 PRP injections into the joint and two other groups of patients were treated with HA injections. One group was treated with injections of high-molecular weight HA (thicker HA like SynVisc); the other group was treated with low-molecular weight HA (thinner HA like Hyalgan). At 2 months’ follow-up, the PRP and thinner HA groups showed a similar improvement, with better results compared with the high-molecular weight HA group (thicker HA). At 6 months’ follow-up, better results were observed in the PRP group. PRP and HA treatments offered similar results in patients 50 or older. The conclusion states that better results were seen in younger and more active patients who had a low degree of cartilage degeneration, whereas a worse outcome was seen in more advanced knee arthritis joints and in older patients. The upshot? PRP seems to work better than HA and neither works well in patients with more severe arthritis. This fits with what we see in our Colorado clinic, with many of our successful knee stem cell patients already having failed PRP and HA. This also fits with other recent studies showing that PRP is better than steroid shots for problems like plantar fascititis.