Hyaluronic Acid Versus Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Literature Review
DOI:
https://doi.org/10.12775/QS.2026.68.74364Keywords
knee osteoarthritis, platelet-rich plasma, hyaluronic acid, viscosupplementation, orthobiologics, intra-articular injectionsAbstract
Background: Knee osteoarthritis (KOA) is a prevalent chronic degenerative condition and a leading cause of global disability. Intra-articular injections, specifically Hyaluronic Acid (HA) and Platelet-Rich Plasma (PRP), serve as critical non-surgical interventions when standard conservative therapies fail. Despite their widespread use, there is no universal consensus on which modality offers superior clinical outcomes.
Aim: This literature review aims to systematically evaluate and synthesize current evidence from 2020 to 2026 comparing the efficacy and safety of intra-articular HA versus PRP for the treatment of knee osteoarthritis.
Methodology: A review was conducted using the PubMed database, focusing on peer-reviewed literature from recent meta-analyses, systematic reviews, and randomized controlled trials published between 2020 and 2026.
Results: The findings indicate that while both HA and PRP are safe and effective in the short term (1–3 months), PRP demonstrates statistically and clinically superior results in terms of pain reduction and functional improvement at mid-to-long-term follow-ups (6–12 months). Long-term studies suggest that PRP provides a more sustained therapeutic effect, with significantly higher joint survival rates compared to HA over 7 years. Furthermore, emerging evidence identifies PRP+HA combination therapy as a potentially optimal strategy, ranking highest for long-term efficacy by leveraging both mechanical lubrication and biological modulation. Both treatments maintain comparable safety profiles, characterized primarily by transient, local adverse events.
Conclusion: PRP represents a superior conservative treatment for mild-to-moderate KOA compared to HA, particularly for patients seeking durable symptomatic relief. For clinical practice, PRP or combination therapy is recommended to achieve optimal long-term outcomes and potentially delay the progression toward invasive surgical interventions.
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Copyright (c) 2026 Tomasz Adam Szczepanowski, Bartosz Zawadzki, Natalia Kornacka, Jakub Zwardoń, Katarzyna Naja, Miłosz Rewekant, Zuzanna Walczak, Anna Świerczek, Aleksander Gajkowski, Krzysztof Bednarski
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